Provider Demographics
NPI:1952403792
Name:SPOFFORD, HOWARD ANDREW (LMT)
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:ANDREW
Last Name:SPOFFORD
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 RIVERDALE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7240
Mailing Address - Country:US
Mailing Address - Phone:843-327-4793
Mailing Address - Fax:
Practice Address - Street 1:16 RIVERDALE DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7240
Practice Address - Country:US
Practice Address - Phone:843-327-4793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3962174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC3962OtherSC STATE LICENSE # LMT