Provider Demographics
NPI:1588627772
Name:SPICER, GALIN J (MD)
Entity Type:Individual
Prefix:
First Name:GALIN
Middle Name:J
Last Name:SPICER
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2097 HENRY TECKLENBURG DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-5740
Mailing Address - Country:US
Mailing Address - Phone:843-763-7741
Mailing Address - Fax:843-763-2114
Practice Address - Street 1:2097 HENRY TECKLENBURG DR
Practice Address - Street 2:SUITE 204
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5740
Practice Address - Country:US
Practice Address - Phone:843-763-7741
Practice Address - Fax:843-763-2114
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC26761207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP4019Medicaid
SCGP4019Medicaid