Provider Demographics
NPI:1134584907
Name:SPANOS, DAVID JOSEPH (MED, MSN, RN, LSN)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JOSEPH
Last Name:SPANOS
Suffix:
Gender:M
Credentials:MED, MSN, RN, LSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 SUPERIOR AVE E
Mailing Address - Street 2:SUITE 1800
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-2522
Mailing Address - Country:US
Mailing Address - Phone:440-888-3260
Mailing Address - Fax:
Practice Address - Street 1:1111 SUPERIOR AVE E
Practice Address - Street 2:SUITE 1800
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-2522
Practice Address - Country:US
Practice Address - Phone:440-888-3260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-22
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH345885163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse