Provider Demographics
NPI:1467438440
Name:SPEAR, ROSANNA C (DO)
Entity Type:Individual
Prefix:
First Name:ROSANNA
Middle Name:C
Last Name:SPEAR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1240 S BROAD ST STE 130
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-5395
Mailing Address - Country:US
Mailing Address - Phone:215-361-5040
Mailing Address - Fax:215-393-5441
Practice Address - Street 1:1240 S BROAD ST STE 130
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-5395
Practice Address - Country:US
Practice Address - Phone:215-361-5040
Practice Address - Fax:215-393-5441
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS010524L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H78081Medicare UPIN