Provider Demographics
NPI:1225018732
Name:SPERANZA, DAVID N (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:N
Last Name:SPERANZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-339-3125
Mailing Address - Fax:717-339-3108
Practice Address - Street 1:37 N 5TH ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2004
Practice Address - Country:US
Practice Address - Phone:717-339-2424
Practice Address - Fax:717-334-6659
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-043824-E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1522411OtherGATEWAY
PA1165945Medicaid
PA30153381OtherAMERIHEALTH CARITAS PA - WMG
PA424456OtherHIGHMARK BLUE SHIELD
PA30153381OtherAMERIHEALTH CARITAS PA - WMG
PA424456FLTMedicare PIN
PAP01245100Medicare PIN
PASP424456Medicare ID - Type Unspecified