Individual
GITA G SPRAGUE
Active
Individual
GITA G SPRAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R1G86
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001331700
COMMUNITY HEALTH PLAN
MO
05
—
100099580N
—
KS
01
—
1008065
AETNA
MS
01
—
22979012
BLUE CROSS BLUE SHIELD
MO
05
—
540156809
—
MO
01
—
603723
BLUE CROSS BLUE SHIELD
KS
Enumeration date
07/04/2006
Last updated
12/28/2020
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