Healthcare Provider Details

I. General information

NPI: 1487819769
Provider Name (Legal Business Name): JOHN D. SPRANDIO JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2008
Last Update Date: 02/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 LAWRENCE RD SUITE 201
BROOMALL PA
19008-3301
US

IV. Provider business mailing address

30 LAWRENCE RD SUITE 201
BROOMALL PA
19008-3301
US

V. Phone/Fax

Practice location:
  • Phone: 610-492-5900
  • Fax: 610-492-5903
Mailing address:
  • Phone: 610-492-5900
  • Fax: 610-492-5903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD444010
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: