Provider Demographics
NPI:1861598849
Name:SPEARS, DAVID (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SPEARS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 COLEGATE DR BLDG 3
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-9549
Mailing Address - Country:US
Mailing Address - Phone:740-374-6090
Mailing Address - Fax:740-374-3165
Practice Address - Street 1:300 E 8TH ST STE 121
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3379
Practice Address - Country:US
Practice Address - Phone:740-374-7464
Practice Address - Fax:740-373-1562
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.008838207Q00000X
OH34008838207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2712738Medicaid
WV3810007596Medicaid
OH2712738Medicaid
WV3810007596Medicaid
OH2712738Medicaid
OHP00131500OtherRAILROAD MEDICARE - SELBY
OHP01254437OtherRAILROAD MEDICARE - MHCPI