Individual
JOHN EDWARD SPENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 BLYTHE BLVD., MEDICAL CENTER PLAZA, SUITE 200, CHARLOTTE, NC 28203-5865
(704) 381-8840
(704) 381-8848
Mailing address
PO BOX 601372, CHARLOTTE, NC 28260-1372
(704) 381-8840
(707) 381-8848
Taxonomy
Speciality
Code
Description
License number
State
207SC0300X
Clinical Cytogenetics Physician
40000
NC
207SG0201X
Clinical Genetics (M.D.) Physician
40000
NC
208000000X
Pediatrics Physician
Primary
40000
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366467649
—
NC
01
—
78721
NCBCBS
NC
05
—
8978721
—
NC
05
—
N40000
—
SC
Enumeration date
07/13/2006
Last updated
03/01/2024
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