Basic Information
| Provider Information | |||||||||
| NPI: | 1528062916 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPAR | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 475 N WEABER ST | ||||||||
| Address2: | |||||||||
| City: | ANNVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170031104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178674671 | ||||||||
| FaxNumber: | 7178672418 | ||||||||
| Practice Location | |||||||||
| Address1: | 475 N WEABER ST | ||||||||
| Address2: | |||||||||
| City: | ANNVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170031104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178674671 | ||||||||
| FaxNumber: | 7178672418 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD022298E | PA | X | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | MD022298E | PA | X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.