Healthcare Provider Details

I. General information

NPI: 1497289367
Provider Name (Legal Business Name): ALEXANDER SPYROS MARIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2017
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E WOOD ST
SPARTANBURG SC
29303-3040
US

IV. Provider business mailing address

PO BOX 96782
CHARLOTTE NC
28296-6782
US

V. Phone/Fax

Practice location:
  • Phone: 225-663-9556
  • Fax:
Mailing address:
  • Phone: 704-973-5500
  • Fax: 704-464-0386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number2022-00930
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License NumberMD87232
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: