Healthcare Provider Details

I. General information

NPI: 1942289509
Provider Name (Legal Business Name): MARK SANFORD SPRINGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 10/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6081 HAMILTON BLVD STE 101
ALLENTOWN PA
18106-9801
US

IV. Provider business mailing address

1605 N CEDAR CREST BLVD STE. 110B
ALLENTOWN PA
18104-2351
US

V. Phone/Fax

Practice location:
  • Phone: 610-841-4404
  • Fax: 484-403-4026
Mailing address:
  • Phone: 610-973-1410
  • Fax: 610-973-1449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-039542-E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: