# SPENCER FAMILY PRACTICE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568032464
- **Authorized official:** MRS. MARY L SPENCER NP (CEO/ OWNER)
- **Authorized official phone:** (434) 390-6641

## Contact information

- **Practice address:** 8061 SPRINGFIELD RD, GLENN DALE, MD 20769-9605
- **Practice address phone:** (434) 390-6641
- **Practice address fax:** (240) 206-3855
- **Mailing address:** 8061 SPRINGFIELD RD, GLENN DALE, MD 20769-9605
- **Mailing address phone:** (434) 390-6641
- **Mailing address fax:** (240) 206-3855

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/01/2021
- **Last updated:** 07/01/2021