Individual
DAVID SPECIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 395-6388
Mailing address
8 MERRIFIELD CT, GREENVILLE, SC 29615-3432
(864) 395-6388
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5046
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6469PA
—
SC
01
—
SCR2998510
MEDICARE PIN
SC
01
—
SCR2999068
MEDICARE PIN
SC
Enumeration date
07/24/2023
Last updated
01/02/2024
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