Provider Demographics
NPI:1417018375
Name:DAVID A. SPOTT, M.D., P.A.
Entity Type:Organization
Organization Name:DAVID A. SPOTT, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SPOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-868-7077
Mailing Address - Street 1:9131 PISCATAWAY RD
Mailing Address - Street 2:SUITE 550
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2508
Mailing Address - Country:US
Mailing Address - Phone:301-868-7077
Mailing Address - Fax:301-856-0767
Practice Address - Street 1:9131 PISCATAWAY RD
Practice Address - Street 2:SUITE 550
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2508
Practice Address - Country:US
Practice Address - Phone:301-868-7077
Practice Address - Fax:301-856-0767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0015375207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty