Physician Compare National (NPI:1457362576)

HEALTHCARE PROVIDER: GARY ROBERT SPIVACK M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1457362576
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2769660802
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110621000060
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SPIVACK
	Individual professional last name
Provider First Name	GARY
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1974
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2501 N GLEBE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 303
	Group Practice or individual's line 2 address
City	ARLINGTON
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	222073558
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y