Provider Demographics
NPI:1720213895
Name:SPITZ, STEVEN MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MARK
Last Name:SPITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:470 NORTHSIDE CHEROKEE BLVD STE 375
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-8029
Mailing Address - Country:US
Mailing Address - Phone:770-422-0444
Mailing Address - Fax:770-422-4412
Practice Address - Street 1:470 NORTHSIDE CHEROKEE BLVD STE 375
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-8029
Practice Address - Country:US
Practice Address - Phone:770-422-0444
Practice Address - Fax:770-422-4412
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA73656207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program