Basic Information
| Provider Information | |||||||||
| NPI: | 1720063662 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPIELVOGEL | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14275 MIDWAY DRIVE | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | ADDISON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750013676 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2149328018 | ||||||||
| FaxNumber: | 6102714245 | ||||||||
| Practice Location | |||||||||
| Address1: | 3805 W CHESTER PIKE | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | NEWTOWN SQUARE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190732329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002570117 | ||||||||
| FaxNumber: | 6105503079 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2005 | ||||||||
| LastUpdateDate: | 12/23/2013 | ||||||||
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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 | 207N00000X | MD043524E | PA | N | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | G6401 | TX | N | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | G61072 | CA | N | Allopathic & Osteopathic Physicians | Dermatology | 207ND0900X | MD043524E | PA | Y | Allopathic & Osteopathic Physicians | Dermatology | Dermatopathology | 207ND0900X | G61072 | CA | N | Allopathic & Osteopathic Physicians | Dermatology | Dermatopathology | 207ND0900X | G6401 | TX | N | Allopathic & Osteopathic Physicians | Dermatology | Dermatopathology |
No ID Information.