1194958611 NPI number — ADAM PETER SPIRA PH.D.

Table of content: ADAM PETER SPIRA PH.D. (NPI 1194958611)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194958611 NPI number — ADAM PETER SPIRA PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPIRA
Provider First Name:
ADAM
Provider Middle Name:
PETER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194958611
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/01/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
624 N BROADWAY
Provider Second Line Business Mailing Address:
HAMPTON HOUSE, RM 794
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21205-1900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-614-9498
Provider Business Mailing Address Fax Number:
410-614-7469

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
THE JOHNS HOPKINS OUTPATIENT CTR STE 1261
Provider Second Line Business Practice Location Address:
601 N. CAROLINE STREET
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21287-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-287-3313
Provider Business Practice Location Address Fax Number:
443-287-3312
Provider Enumeration Date:
09/01/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  04619 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103T00000X , with the licence number: PSY 21591 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)