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General NPI Number Information
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NPI Number | 1265535512
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Entity Type | Individual
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Provider Name | SPIRO B ANTONIADES MD
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Gender | Male
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 2014 S TOLLGATE RD STE 107
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City | BEL AIR
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State | MD
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Zip | 21015-6010
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Country | US
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Telephone | 410-446-8747
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Fax | 443-643-2088
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Provider Business Mailing Address
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Address Line | 2014 S TOLLGATE RD STE 107
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City | BEL AIR
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State | MD
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Zip | 21015-6010
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Country | US
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Telephone | 410-877-7776
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Fax | 443-402-1221
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | D0047688
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | D0047688
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License Number State | MD
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