Provider Demographics
NPI:1477602795
Name:SPENCER, ROBERT F (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:F
Last Name:SPENCER
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:PO BOX 2552
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03302-2552
Mailing Address - Country:US
Mailing Address - Phone:603-228-7160
Mailing Address - Fax:603-228-7168
Practice Address - Street 1:130 PEMBROKE RD
Practice Address - Street 2:STE. 250
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5792
Practice Address - Country:US
Practice Address - Phone:603-228-7160
Practice Address - Fax:603-228-7168
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9752207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30009837Medicaid
NH30009837Medicaid
NHRE4294Medicare ID - Type Unspecified