Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 4301055796 | MI |
NPI | 1053393819 |
---|---|
Provider Name | Dr. William F Spencer |
First Address | Royal Oak, MI 48073-0926 |
Second Address | Royal Oak, MI 48073-0926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 12/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
131404 | PREFERRED CARE CHOICES (01) | MI |
266621010 | (05) | MI |
340003663 | RAILROAD MEDICARE (01) | MI |
3406313451 | BCBSM INDIVIDUAL NUMBER (01) | MI |
4406806 | AETNA (01) | MI |
4973461 | (05) | MI |
C7403 | MCARE (01) | MI |
E62011 | (02) | |
E62011 | HAP (01) | MI |
WS055796 | BLUE SHEILD LICENSE NUMBE (01) | MI |