Provider Demographics
NPI:1164428314
Name:SPERING, MARK ANDREW (OD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:ANDREW
Last Name:SPERING
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2337 SCHOENERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7416
Mailing Address - Country:US
Mailing Address - Phone:610-867-1182
Mailing Address - Fax:610-866-2196
Practice Address - Street 1:2337 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7416
Practice Address - Country:US
Practice Address - Phone:610-867-1182
Practice Address - Fax:610-866-2196
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000088152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU50752Medicare UPIN
PA191503Medicare PIN
PA4708100001Medicare NSC