Provider Demographics
NPI:1780882969
Name:SPATZ, CHRISTIN MARY (MD)
Entity type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:MARY
Last Name:SPATZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTIN
Other - Middle Name:MARY
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 GUTHRIE SQ
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840-1625
Mailing Address - Country:US
Mailing Address - Phone:570-888-5858
Mailing Address - Fax:
Practice Address - Street 1:1 GUTHRIE SQ
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:PA
Practice Address - Zip Code:18840-1625
Practice Address - Country:US
Practice Address - Phone:570-888-5858
Practice Address - Fax:570-887-2699
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD439943207R00000X, 208M00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2673171OtherHIGHMARK BLUE SHIELD
PA418042OtherUPMC
PA30110958OtherAMERIHEALTH MERCY - WMG
PA1609396OtherGATEWAY
PA102653582Medicaid
PA102653582Medicaid
PAP01343731Medicare PIN