Provider Demographics
NPI:1174573208
Name:SPEARS, NYASHA LM (MD)
Entity type:Individual
Prefix:DR
First Name:NYASHA
Middle Name:LM
Last Name:SPEARS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:26 E SUPERIOR ST
Mailing Address - Street 2:STE. 205
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-2124
Mailing Address - Country:US
Mailing Address - Phone:218-249-4300
Mailing Address - Fax:218-249-4350
Practice Address - Street 1:26 E SUPERIOR ST
Practice Address - Street 2:STE. 205
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-2124
Practice Address - Country:US
Practice Address - Phone:218-249-4300
Practice Address - Fax:218-249-4350
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2017-01-31
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Provider Licenses
StateLicense IDTaxonomies
WI47149207Q00000X
MN44835207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34591300Medicaid
WI34591300Medicaid
WIH75764Medicare UPIN