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General NPI Number Information
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NPI Number | 1386653947
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Entity Type | Individual
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Provider Name | MICHAEL P SPENCER MD
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 6363 FRANCE AVE S STE 400
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City | EDINA
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State | MN
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Zip | 55435-2142
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Country | US
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Telephone | 651-312-1700
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Fax | 952-920-4148
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Provider Business Mailing Address
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Address Line | 2550 UNIVERSITY AVE W STE 110N
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City | SAINT PAUL
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State | MN
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Zip | 55114-8693
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Country | US
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Telephone | 651-602-5312
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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 | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 30322
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License Number State | MN
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