Provider Demographics
NPI:1083870240
Name:SPIELER, PHYLLIS (MD)
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:
Last Name:SPIELER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 HAVERHILL ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-1509
Mailing Address - Country:US
Mailing Address - Phone:978-470-1902
Mailing Address - Fax:978-749-3605
Practice Address - Street 1:138 HAVERHILL ST
Practice Address - Street 2:SUITE 102
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-1509
Practice Address - Country:US
Practice Address - Phone:978-470-1902
Practice Address - Fax:978-749-3605
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA45717207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0110213Medicaid
MAD82806Medicare UPIN
D02062Medicare PIN