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NPI Code Detail

MEDICARE: DR. NAVARO NOAH SPARTACO M.D.

MEDICARE: DR. NAVARO NOAH SPARTACO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician036-109038IL

General Provider Information

NPI Number : 1013164532
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NAVARO NOAH SPARTACO M.D.
Provider Business Mailing Address
First Line : 357 E EASTGATE PL
Second Line :
City : CHICAGO
State : IL
Zip : 60616-5503
Country : US
Telephone Number : 773-495-6022
Fax Number :
Provider Business Practice Location Address
First Line : 5444 AVE O
Second Line :
City : FORT MADISON
State : IA
Zip : 52627
Country : US
Telephone Number : 319-495-6022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2008
Last Update Date : 10/26/2009

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