Provider Demographics
NPI:1538252770
Name:SPIELMAN, STEVEN B (PHD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:B
Last Name:SPIELMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FERN WAY
Mailing Address - Street 2:
Mailing Address - City:MADBURY
Mailing Address - State:NH
Mailing Address - Zip Code:03823-7566
Mailing Address - Country:US
Mailing Address - Phone:603-749-0727
Mailing Address - Fax:603-749-0727
Practice Address - Street 1:875 GREENLAND RD
Practice Address - Street 2:SUITE B-4
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4164
Practice Address - Country:US
Practice Address - Phone:603-749-0727
Practice Address - Fax:603-749-0727
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH759103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30008897Medicaid
ST RE3920Medicare ID - Type UnspecifiedMEDICARE GROUP
SP RE3917Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL