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General NPI Number Information
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NPI Number | 1275559163
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Entity Type | Individual
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Provider Name | LORI DIANE SPISAK MD
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Gender | Female
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 102 HANDLEY PARK CT
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City | GOLDSBORO
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State | NC
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Zip | 27534-1768
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Country | US
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Telephone | 919-734-3344
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Fax | 919-735-3025
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Provider Business Mailing Address
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Address Line | 5221 PARAMOUNT PKWY STE 220
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City | MORRISVILLE
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State | NC
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Zip | 27560-5490
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Country | US
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Telephone |
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Fax |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4301077897
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 2022-00284
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License Number State | NC
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