Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | TA1325 | MD |
NPI | 1003843152 |
---|---|
Provider Name | Dr. Stuart Brian Spind |
First Address | Glen Burnie, MD 21061-5577 |
Second Address | Glen Burnie, MD 21061-5577 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 10/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
016788600 | (05) | MD |
410035026 | RAILROAD MEDICARE (01) | MD |
U62519 | (02) | MD |