Provider Demographics
NPI:1902902869
Name:SPENCE, IAN JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:JAMES
Last Name:SPENCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4990 SENTINEL DR
Mailing Address - Street 2:APT. 406
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-3601
Mailing Address - Country:US
Mailing Address - Phone:301-320-5547
Mailing Address - Fax:301-320-8253
Practice Address - Street 1:VETERANS ADMINISTRATION HOSPITAL
Practice Address - Street 2:50 IRVING ST
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422-0001
Practice Address - Country:US
Practice Address - Phone:202-745-8295
Practice Address - Fax:202-745-8293
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD3461174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist