Provider Demographics
NPI:1093170151
Name:EVANGELINE J. SPINDLER, MD
Entity Type:Organization
Organization Name:EVANGELINE J. SPINDLER, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVANGELINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:SPINDLER MD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-665-2457
Mailing Address - Street 1:2737 NEWPORT RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-2281
Mailing Address - Country:US
Mailing Address - Phone:734-665-2457
Mailing Address - Fax:
Practice Address - Street 1:2737 NEWPORT RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-2281
Practice Address - Country:US
Practice Address - Phone:734-665-2457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301027237261QM0801X, 261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)