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General NPI Number Information
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NPI Number | 1598159014
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Entity Type | Organization
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Legal Business Name | FREDERIC C. SPECTOR DPM PC
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Dates
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Enumeration Date | 03/23/2015
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Last Update Date | 03/23/2015
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Provider Practice Location Address
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Address Line | 352 COMMERCIAL DR
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City | SAVANNAH
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State | GA
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Zip | 31406-3616
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Country | US
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Telephone | 912-354-3668
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Fax | 912-354-0662
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Provider Business Mailing Address
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Address Line | PO BOX 13040
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City | SAVANNAH
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State | GA
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Zip | 31416-0040
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Country | US
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Telephone | 912-354-3668
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Fax | 912-354-0662
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Authorized Official
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Title or Position | PRESIDENT
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Name | FREDERIC C. SPECTOR
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Credential | D.P.M.
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Telephone | 912-354-3668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | POD000484
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License Number State | GA
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