Provider Demographics
NPI:1053361436
Name:SPIELBERG, STEPHEN PAUL (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:PAUL
Last Name:SPIELBERG
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 GOLDENROD DR
Mailing Address - Street 2:
Mailing Address - City:UPPER GWYNEDD
Mailing Address - State:PA
Mailing Address - Zip Code:19446-7605
Mailing Address - Country:US
Mailing Address - Phone:215-699-4984
Mailing Address - Fax:
Practice Address - Street 1:201 GOLDENROD DR
Practice Address - Street 2:
Practice Address - City:UPPER GWYNEDD
Practice Address - State:PA
Practice Address - Zip Code:19446-7605
Practice Address - Country:US
Practice Address - Phone:215-699-4984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD048341L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics