Provider Demographics
NPI:1144268913
Name:SPRANDIO, JOHN D (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:SPRANDIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:30 LAWRENCE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-3301
Mailing Address - Country:US
Mailing Address - Phone:610-492-5900
Mailing Address - Fax:610-492-5810
Practice Address - Street 1:30 LAWRENCE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-3301
Practice Address - Country:US
Practice Address - Phone:610-492-5900
Practice Address - Fax:610-492-5810
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD026266E207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4084568OtherAETNA
PA0011349490003Medicaid
PA0083003000OtherIBC
PA830002321OtherRR MEDICARE
PA137658OtherPA BLUE SHIELD
PA137658OtherPA BLUE SHIELD
PA4084568OtherAETNA