Provider Demographics
NPI:1568502599
Name:SPRING, MICHELE DONNA (MD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:DONNA
Last Name:SPRING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 EAST ADAMS ST
Mailing Address - Street 2:4TH FL
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210
Mailing Address - Country:US
Mailing Address - Phone:315-464-5831
Mailing Address - Fax:315-642-2030
Practice Address - Street 1:725 EAST ADAMS ST
Practice Address - Street 2:4TH FL
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-464-5831
Practice Address - Fax:315-642-2030
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD385782080P0208X
NY2903962080P0208X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNBS9821225OtherDEA