Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 36789 | SC |
Y | 2081P2900X | Pain Medicine | 69715 | GA |
NPI | 1407083207 |
---|---|
Provider Name | Gregory O Spellman |
First Address | Savannah, GA 31405-3662 |
Second Address | Savannah, GA 31405-3662 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2009 |
Last Update Date | 09/03/2020 |