Provider Demographics
NPI:1548378722
Name:SPEARMAN, DAVID RONALD (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:RONALD
Last Name:SPEARMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:R
Other - Last Name:SPEARMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1 FREEDOM WAY
Mailing Address - Street 2:CHARLIE NORWOOD VA MEDICAL CENTER
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-6258
Mailing Address - Country:US
Mailing Address - Phone:706-733-0188
Mailing Address - Fax:706-823-3960
Practice Address - Street 1:1 FREEDOM WAY
Practice Address - Street 2:CHARLIE NORWOOD VA MEDICAL CENTER
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-6258
Practice Address - Country:US
Practice Address - Phone:706-733-0188
Practice Address - Fax:706-823-3960
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA17310207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000119039BMedicaid
GA17310OtherGEORGIA LICENSE STATE
GA000119039BMedicaid