Provider Demographics
NPI:1023274354
Name:SPANN, JAMES FLETCHER (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:FLETCHER
Last Name:SPANN
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 1:812 ROBERT E LEE BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-9134
Mailing Address - Country:US
Mailing Address - Phone:843-870-8736
Mailing Address - Fax:886-482-9782
Practice Address - Street 1:812 ROBERT E LEE BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-9134
Practice Address - Country:US
Practice Address - Phone:843-870-8736
Practice Address - Fax:886-482-9782
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD12591207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease