Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | G61072 | CA |
N | 207N00000X | Dermatologist | G6401 | TX |
N | 207N00000X | Dermatologist | MD043524E | PA |
N | 207ND0900X | Dermatopathologist | G61072 | CA |
N | 207ND0900X | Dermatopathologist | G6401 | TX |
Y | 207ND0900X | Dermatopathologist | MD043524E | PA |
NPI | 1720063662 |
---|---|
Provider Name | Dr. Richard L. Spielvogel |
First Address | Addison, TX 75001-3676 |
Second Address | Newtown Square, PA 19073-2329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 23/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B58059 | (02) |