Healthcare Provider Details

I. General information

NPI: 1780635276
Provider Name (Legal Business Name): LAURENCE J. SPITZER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 W GERMANTOWN PIKE
EAST NORRITON PA
19403-4250
US

IV. Provider business mailing address

PO BOX 820137
PHILADELPHIA PA
19182-0137
US

V. Phone/Fax

Practice location:
  • Phone: 484-622-0700
  • Fax: 484-622-0643
Mailing address:
  • Phone: 610-270-2352
  • Fax: 610-270-2358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberMD056520L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD056520L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: