Provider Demographics
NPI:1205804440
Name:SPIRO, THOMAS (PA)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:SPIRO
Suffix:
Gender:M
Credentials:PA
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:370 FAUNCE CORNER ROAD
Mailing Address - Street 2:SOUTHCOAST PHYSICIAN SERVICES, INC.
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1271
Mailing Address - Country:US
Mailing Address - Phone:508-985-2000
Mailing Address - Fax:508-985-2001
Practice Address - Street 1:100 ROSEBROOK WAY
Practice Address - Street 2:SOUTHCOAST PHYSICIAN SERVICES, INC 2ND FLOOR
Practice Address - City:WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02571-2097
Practice Address - Country:US
Practice Address - Phone:508-273-4950
Practice Address - Fax:508-273-4951
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2011-06-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA249363A00000X
MAPA249363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S31465Medicare UPIN
MAAP0025Medicare ID - Type Unspecified