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Individual

DR. BRIAN SPONSELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3073 WHITE MOUNTAIN HWY, NORTH CONWAY, NH 03860-7101
(603) 356-5472
Mailing address
PO BOX 2540, NORTH CONWAY, NH 03860-2540
(603) 356-5472

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14575
NH
207Q00000X
Family Medicine Physician
2299-850
WI
207Q00000X
Family Medicine Physician
50976-20
WI

Other

Enumeration date
10/17/2007
Last updated
08/16/2010
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