Healthcare Provider Details
I. General information
NPI: 1407810682
Provider Name (Legal Business Name): WILLIAM SPENCER-STRONG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3333 N CALVERT ST JOHNSTON PROF BLDG, STE 210
BALTIMORE MD
21218-2867
US
IV. Provider business mailing address
3333 N CALVERT ST JOHNSTON PROF BLDG, STE 210
BALTIMORE MD
21218-2867
US
V. Phone/Fax
- Phone: 410-554-2223
- Fax:
- Phone: 410-554-2223
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | D0009433 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: