Provider Demographics
NPI:1336373406
Name:SPIER, ADDIE (MD)
Entity Type:Individual
Prefix:
First Name:ADDIE
Middle Name:
Last Name:SPIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 HENDERSON ST STE C
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2648
Mailing Address - Country:US
Mailing Address - Phone:803-865-4715
Mailing Address - Fax:803-865-4716
Practice Address - Street 1:1730 HENDERSON ST STE C
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2648
Practice Address - Country:US
Practice Address - Phone:803-865-4715
Practice Address - Fax:803-865-4716
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036140938207RI0200X
SC90878207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-140938OtherIL LICENSE
SC90878OtherSC MEDICAL LICENSE
ILF400306946Medicare PIN
ILF400306945Medicare PIN
ILF400306944Medicare PIN
IL036-140938OtherIL LICENSE