Provider Demographics
NPI:1215011416
Name:SPENCER, DEBORAH VINSON (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:VINSON
Last Name:SPENCER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 BEE ST
Mailing Address - Street 2:VA MEDICAL CENTER
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-5703
Mailing Address - Country:US
Mailing Address - Phone:843-789-7466
Mailing Address - Fax:
Practice Address - Street 1:109 BEE ST
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-5703
Practice Address - Country:US
Practice Address - Phone:843-789-7466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28927207ZP0102X
NC2011-01090207ZP0102X
SCLL 28927207ZP0102X
ALMD.31726207ZP0102X
GA68003207ZP0102X
FLME 121140207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology