Healthcare Provider Details

I. General information

NPI: 1982756573
Provider Name (Legal Business Name): VLADIMIR SPIRA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 08/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 W 11TH ST
SILVER CITY NM
88061-5136
US

IV. Provider business mailing address

530 DEMOSS STREET
LORDSBURG NM
88045-2618
US

V. Phone/Fax

Practice location:
  • Phone: 575-388-1511
  • Fax: 575-388-3465
Mailing address:
  • Phone: 575-542-8384
  • Fax: 575-542-8367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number032819
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD2008-0744
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: