Provider Demographics
NPI:1699018010
Name:SPRUNG, GREGORY MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:MICHAEL
Last Name:SPRUNG
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 1:1745 N MILLS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1876
Mailing Address - Country:US
Mailing Address - Phone:407-841-7151
Mailing Address - Fax:
Practice Address - Street 1:2535 S DOWNING ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5847
Practice Address - Country:US
Practice Address - Phone:303-744-1065
Practice Address - Fax:303-733-1699
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-03
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-01166207RC0000X
FLME139817207RC0000X
CODR.69443207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty