Healthcare Provider Details
I. General information
NPI: 1538242979
Provider Name (Legal Business Name): JAMES SPRINGATE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/21/2006
Last Update Date: 09/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
219 BRYANT ST
BUFFALO NY
14222-2006
US
IV. Provider business mailing address
4511 HARLEM RD SUITE 202
AMHERST NY
14226-3803
US
V. Phone/Fax
- Phone: 716-878-7275
- Fax: 716-888-3801
- Phone: 716-839-6720
- Fax: 716-839-6740
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0210X |
| Taxonomy | Pediatric Nephrology Physician |
| License Number | 157599 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: