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Individual

DR. JEREMY THOMAS SPENCER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8260
Mailing address
PO BOX 14045, RALEIGH, NC 27620-4045
(919) 350-8260

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
0101247173
VA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD.205541
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06903245
MS
05
2302612
LA
Enumeration date
03/12/2010
Last updated
04/15/2021
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