MICHAEL SPACK (NPI# 1073573572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073573572 |
| Entity Type | Individual |
| Full Name | MICHAEL SPACK |
| Credential | PA |
| Practice Address |
1342 South Division Street Unit 401, Peninsula Urology Associates Pa Salisbury MD 21084 |
| Practice Telephone | 4105462133 |
| Practice Fax Number | 4105483361 |
| Mailing Telephone | 4105462133 |
| Mailing Fax Number | 4105483361 |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | C0001119 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1342 SOUTH DIVISION STREET UNIT 401, PENINSULA UROLOGY ASSOCIATES PA |
| City | SALISBURY |
| State | MD |
| Zip Code | 21084 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356301840 | Christopher D Maull | Urology | 1342 South Division Street, Unit 401, Peninsula Urology Associates Pa, Salisbury, MD 21084 | 2006-03-27 |
| 1154432300 | Salisbury Uro Surgery Center LLC | Urology | 1342 South Division Street, Unit 401, Salisbury, MD 21804 | 2006-08-31 |
| 1891756748 | Harold I Genvert | Urology | 1342 South Division Street, Unit 401, Salisbury, MD 21084 | 2006-03-30 |
| 1184684789 | Mark T Edney | Urology | 1342 South Division Street, Unit 401 Peninsula Urology Associates Pa, Salisbury, MD 21084 | 2006-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760544589 | Jarrettsville Volunteer Fire Co Inc. | Ambulance | 3825 Federal Hill Rd, Jarrettsville, MD 21084 | 2006-12-15 |
| 1790272110 | Rachel Lynn Kendzejeski | Social Worker | 1714 Jarrettsville Rd, Jarrettsville, MD 21084 | 2018-04-20 |
| 1528378270 | Capri Joyce Digiovanni | Pharmacist | 3714 Norrisville Rd, Jarrettsville, MD 21084 | 2010-10-15 |
| 1942550421 | Lion and Lamb Transportation and Care Inc. | Non-emergency Medical Transport (VAN) | 4154 Madonna Rd, Jarrettsville, MD 21084-1031 | 2012-09-12 |
| 1447604137 | Christopher Mckay | Obstetrics & Gynecology | 4113 Manor View Ct, Jarrettsville, MD 21084-1112 | 2016-04-19 |
| 1639418171 | Jeffrey Lewis Selznick | Dentist | 1818 Midsummer Ln, Jarrettsville, MD 21084-1200 | 2013-02-04 |
| 1982029088 | Stephanie Merle James | Counselor | 1522 N Bend Rd, Jarrettsville, MD 21084-1332 | 2014-02-26 |
| 1003428137 | Courtney Nellies | Speech-Language Pathologist | 1445 N Bend Rd, Jarrettsville, MD 21084-1333 | 2020-08-19 |
| 1174015119 | Rebecca Hughes | Counselor | 1251 N Bend Rd, Jarrettsville, MD 21084-1339 | 2018-06-05 |
| 1295106722 | Kathleen Cullum | Nurse Practitioner | 3718 Norrisville Rd Ste C, Jarrettsville, MD 21084-1419 | 2015-10-09 |
| Find all providers in zip 21084 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609493683 | Haley Rose Thornton | Physician Assistant | 617 Emerald Bay Dr, Salisbury, NC 28146-1582 | 2020-06-25 |
| 1801363262 | Jayme Lynn Isett | Physician Assistant | 314 W Carroll St Ste 1, Salisbury, MD 21801-5409 | 2018-10-24 |
| 1770069353 | Samuel Robert Brittingham | Physician Assistant | 100 E. Carroll St, 3rd Floor, West Tower, Salisbury, MD 21801 | 2018-07-17 |
| 1871950790 | Melissa Noah | Physician Assistant | 31413 Winterplace Pkwy Ste 103, Salisbury, MD 21804-1877 | 2016-01-22 |
| 1013301092 | Megan Way | Physician Assistant | 320 Jake Alexander Blvd W Ste 103, Salisbury, NC 28147-1443 | 2015-03-26 |
| 1932155629 | Lloyd Jeff Taylor | Physician Assistant | 1509 E Innes St, Suite B, Salisbury, NC 28146-6018 | 2006-05-25 |
| 1437119138 | Patricia Deery Adams | Physician Assistant | 1601 Brenner Avenue, Vamc, Salisbury, NC 28144 | 2006-03-25 |
| 1619964327 | Julie Lynn Parrish | Physician Assistant | 314 W Carroll St, Suite 1, Salisbury, MD 21801-5409 | 2005-09-29 |
| 1699778811 | Heidi Elizabeth Callahan | Physician Assistant | 100 E Carroll St, # 400, Salisbury, MD 21801-5422 | 2005-05-23 |
| 1093348609 | Lauren Nolan | Physician Assistant | 612 Mocksville Ave, Salisbury, NC 28144-2732 | 2020-02-21 |
| Find all providers in SALISBURY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.