Individual
DEREK E SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 706-1661
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-5793
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R108156
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
416806200
—
MD
01
—
947321-01 & 02
BC/BS
MD
01
—
S062-0348
BC/BS REGIONAL
MD
Enumeration date
04/10/2008
Last updated
07/16/2009
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