Individual
SPENCER D GREENDYKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3318 N GRAND MILL LN, COEUR D ALENE, ID 83814-5689
(208) 277-1060
(208) 277-1065
Mailing address
3318 N GRAND MILL LN, COEUR D ALENE, ID 83814
(208) 277-1060
(208) 277-1065
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M9110
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807145800
—
ID
Enumeration date
09/21/2005
Last updated
02/23/2012
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