Provider Demographics
NPI:1780635276
Name:SPITZER, LAURENCE J (MD)
Entity Type:Individual
Prefix:
First Name:LAURENCE
Middle Name:J
Last Name:SPITZER
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:PO BOX 820137
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0137
Mailing Address - Country:US
Mailing Address - Phone:610-270-2352
Mailing Address - Fax:610-270-2358
Practice Address - Street 1:559 W GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-4250
Practice Address - Country:US
Practice Address - Phone:484-622-0700
Practice Address - Fax:484-622-0643
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD056520L2085R0202X, 2085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA08722-MD056520LOtherHEALTH PARTNERS
PA0019091710007Medicaid
PA2221773000OtherIBC - PC/KHPE
PAP00037205OtherRRM
PA7939510OtherAETNA PPO
PA1537035OtherHIGHMARK BLUE SHIELD
PA2221773000OtherAMERIHEALTH/INTERCOUNTY
PA3563229OtherCIGNA HMO/PPO
PA3541900OtherAETNA HMO
PA00190917101OtherAMERICHOICE (UHC MA PLAN)
PA30010498OtherKEYSTONE MERCY
PA1537035OtherHIGHMARK BLUE SHIELD
PA3541900OtherAETNA HMO