Healthcare Provider Details

I. General information

NPI: 1457336588
Provider Name (Legal Business Name): STEVEN CARL SPRUILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 11/08/2022
Certification Date: 12/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 W ARLINGTON BLVD
GREENVILLE NC
27834-5704
US

IV. Provider business mailing address

PO BOX 1257
TARBORO NC
27886-1257
US

V. Phone/Fax

Practice location:
  • Phone: 252-413-6641
  • Fax:
Mailing address:
  • Phone: 252-823-6333
  • Fax: 252-823-1406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2003-01295
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: