Healthcare Provider Details

I. General information

NPI: 1306897418
Provider Name (Legal Business Name): CYNTHIA EPSTEIN SPOOLMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 CHILDRENS LN
NORFOLK VA
23507-1910
US

IV. Provider business mailing address

601 CHILDRENS LANE
NORFOLK VA
23507-1910
US

V. Phone/Fax

Practice location:
  • Phone: 757-668-7426
  • Fax: 757-668-7784
Mailing address:
  • Phone: 757-668-7426
  • Fax: 757-668-7784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101055289
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number0101055289
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: