Provider Demographics
NPI:1851599880
Name:SPOMAR, DANIEL GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:GERARD
Last Name:SPOMAR
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 1:13345 ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3318
Mailing Address - Country:US
Mailing Address - Phone:317-851-2663
Mailing Address - Fax:317-851-2664
Practice Address - Street 1:555 E COUNTY LINE RD STE 202
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1063
Practice Address - Country:US
Practice Address - Phone:317-396-1300
Practice Address - Fax:317-957-0037
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36117417207T00000X
IN01065376A207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery