Provider Demographics
NPI:1982685558
Name:SPIRTOS, MANUEL MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:MICHAEL
Last Name:SPIRTOS
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 1:9471 MARKET ST STE B
Mailing Address - Street 2:
Mailing Address - City:NORTH LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:44452-8702
Mailing Address - Country:US
Mailing Address - Phone:330-729-2388
Mailing Address - Fax:330-629-6568
Practice Address - Street 1:9471 MARKET ST STE A
Practice Address - Street 2:
Practice Address - City:NORTH LIMA
Practice Address - State:OH
Practice Address - Zip Code:44452
Practice Address - Country:US
Practice Address - Phone:330-726-7100
Practice Address - Fax:330-758-0347
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-05-6709208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0735986Medicaid