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General NPI Number Information
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NPI Number | 1629030598
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Entity Type | Individual
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Provider Name | AMY M SPRAGUE M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 606 BLACK RIVER RD
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City | GEORGETOWN
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State | SC
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Zip | 29440-3368
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Country | US
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Telephone | 843-527-7000
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Fax | 843-520-8403
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Provider Business Mailing Address
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Address Line | PO BOX 421718
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City | GEORGETOWN
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State | SC
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Zip | 29442-4203
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Country | US
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Telephone | 843-527-7000
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | M-15250
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD195005
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 035145
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M15250
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License Number State | ID
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Taxonomy #5
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | MD195005
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License Number State | OR
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Taxonomy #6
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD61019589
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License Number State | WA
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Taxonomy #7
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD195005
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License Number State | OR
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Taxonomy #8
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 15949
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License Number State | SC
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