Physician Compare National (NPI:1831176858)

HEALTHCARE PROVIDER: MICHAEL STEWART SPICER MD

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

Individual Professional Information
NPI	1831176858
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8820277098
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110120000958
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SPICER
	Individual professional last name
Provider First Name	MICHAEL
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	RUTGERS NEW JERSEY MEDICAL SCHOOL
	Individual professional's medical school
Primary Specialty	DERMATOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	BREVARD MEDICAL DERMATOLOGY, PA
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4688999345
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	7
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	7960 N WICKHAM RAOD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 103
	Group Practice or individual's line 2 address
City	MELBOURNE
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	329408096
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3214284737
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100177
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CAPE CANAVERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y