Healthcare Provider Details

I. General information

NPI: 1295886398
Provider Name (Legal Business Name): ANDREW SPARBER RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 02/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 SOLAREX CT SUITE 201
FREDERICK MD
21703-7005
US

IV. Provider business mailing address

1045 CHERRYWOOD AVE
CUMBERLAND MD
21502-1941
US

V. Phone/Fax

Practice location:
  • Phone: 301-663-8263
  • Fax: 301-682-5326
Mailing address:
  • Phone: 410-938-3464
  • Fax: 410-938-3410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberR052637
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: