Provider Demographics
NPI:1174611339
Name:SPITZ, LAWRENCE K (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:K
Last Name:SPITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1801 MARKET ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-1628
Mailing Address - Country:US
Mailing Address - Phone:215-569-9500
Mailing Address - Fax:215-569-4839
Practice Address - Street 1:1801 MARKET ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-1628
Practice Address - Country:US
Practice Address - Phone:215-569-9500
Practice Address - Fax:215-569-4839
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD014424E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP162170FTFOtherPIN
PASP162170FTFOtherPIN