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Individual

DR. PHILIP ROBERT SPANDORFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, MSCE

Contact information

Practice address
1001 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1605
(404) 785-2275
Mailing address
1902 DENTON WALK CT, MARIETTA, GA 30062-8158

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
055977
GA
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
055977
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
429367238
GA
Enumeration date
04/11/2006
Last updated
08/27/2007
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