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NPI Code Detail

MEDICARE: MR. DAVID PATRICK SPENO MDIV.

MEDICARE:  MR. DAVID PATRICK SPENO  MDIV.
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
1101YP1600XPastoral Counselor

General Provider Information

NPI Number : 1649319336
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID PATRICK SPENO MDIV.
Provider Business Mailing Address
First Line : 1947 EDINBURGH TER NE
Second Line :
City : ATLANTA
State : GA
Zip : 30307-1113
Country : US
Telephone Number : 404-321-1696
Fax Number :
Provider Business Practice Location Address
First Line : 1814 CLAIRMONT RD
Second Line :
City : DECATUR
State : GA
Zip : 30033-3405
Country : US
Telephone Number : 404-636-1457
Fax Number : 404-636-7449
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2007
Last Update Date : 07/08/2007

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Directions to “ MR. DAVID PATRICK SPENO MDIV.” Practice Location

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