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Individual
DR. MARK BRUCE SPAL
Active
Individual
DR. MARK BRUCE SPAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.,R.PH.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00213800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480025935
RAILRAOD MEDICARE
NJ
05
—
5447704
—
NJ
Enumeration date
06/13/2005
Last updated
03/04/2013
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