Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 0101041944 | VA |
NPI | 1114968641 |
---|---|
Provider Name | Dr. Stephen G Spurr |
First Address | Fairfax, VA 22031-2238 |
Second Address | Fairfax, VA 22033-1709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3236940 | ECFMG (01) | |
6717578 | (05) | VA |
6717837 | (05) | VA |
6717845 | (05) | VA |
F78013 | (02) |