Individual
STEPHANIE SPIVACK
Active
Individual
STEPHANIE SPIVACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD472961
PA
207R00000X
Internal Medicine Physician
MT212062
PA
207RI0200X
Infectious Disease Physician
Primary
MD472961
PA
Other
Enumeration date
06/16/2016
Last updated
05/24/2021
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