Provider Demographics
NPI:1336177096
Name:SPEARS, RODERICK (MD)
Entity Type:Individual
Prefix:
First Name:RODERICK
Middle Name:
Last Name:SPEARS
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 1:1001 CHESTERBROOK BLVD
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312-3805
Mailing Address - Country:US
Mailing Address - Phone:610-576-7600
Mailing Address - Fax:
Practice Address - Street 1:1001 CHESTERBROOK BLVD
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-3805
Practice Address - Country:US
Practice Address - Phone:610-576-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4427012084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology