Individual
DEREK T SPRUNGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 PENNSYLVANIA PKWY STE 100, CARMEL, IN 46280-1393
(317) 817-1333
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
(317) 962-4792
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
01035269
IN
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
Primary
01035269
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100132290
—
IN
05
—
100132290C
—
IN
01
—
180016782
RAILROAD MEDICARE
IN
Enumeration date
08/10/2005
Last updated
11/17/2020
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