Individual
ALAN R SPIVACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
313 MORRISTOWN CT, CHESTERFIELD, MO 63017-3426
(314) 275-2211
Mailing address
PO BOX 504214, SAINT LOUIS, MO 63150-0001
(314) 576-1610
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29603
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962491712
RAILROAD MEDICARE NPI
MO
Enumeration date
10/14/2005
Last updated
11/20/2007
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