Individual
DR. STANISLAV SPIVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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