Individual
DR. STANISLAV SPIVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(410) 955-2496
Mailing address
1101 N CALVERT ST APT 306, BALTIMORE, MD 21202-3881
(410) 502-2291
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D0068119
MD
2084P0800X
Psychiatry Physician
JHH RESIDENT LICENSE
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
417882300
—
MD
Enumeration date
01/26/2007
Last updated
06/22/2010
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