Provider Demographics
NPI:1104180595
Name:SPIEGEL, MARC SCOTT (DPM)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:SCOTT
Last Name:SPIEGEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 ROSEMARY ST STE B
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-3259
Mailing Address - Country:US
Mailing Address - Phone:781-444-1129
Mailing Address - Fax:781-444-3666
Practice Address - Street 1:680 CENTRE ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-3308
Practice Address - Country:US
Practice Address - Phone:508-941-7885
Practice Address - Fax:508-941-6337
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2431213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery