Provider Demographics
NPI:1669765525
Name:BACHOW, SPENCER HENICK (MD)
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:HENICK
Last Name:BACHOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6282 LINTON BLVD
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6416
Mailing Address - Country:US
Mailing Address - Phone:561-955-6400
Mailing Address - Fax:561-955-6618
Practice Address - Street 1:6282 LINTON BLVD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6416
Practice Address - Country:US
Practice Address - Phone:561-955-6400
Practice Address - Fax:561-955-6618
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL127498207R00000X, 174400000X, 207RX0202X
FLME127498207RX0202X
NY273983-1207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology