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Individual
RICHARD S SPONG
Active
Individual
RICHARD S SPONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
45487
MN
207RN0300X
Nephrology Physician
Primary
45487
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0072998
—
MT
05
—
0577080
—
IA
01
—
1034834
PREFERREDONE
—
01
—
131139
UCARE
—
01
—
1936380
ARAZ
—
01
—
31-00223
MEDICA - CHOICE
—
05
—
34508900
—
WI
01
—
435R4SP
BLUECROSS BLUESHIELD
MN
05
—
488970300
—
MN
01
—
HP39753
HEALTHPARTNERS
—
Enumeration date
12/28/2005
Last updated
05/17/2012
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