Provider Demographics
NPI:1194958611
Name:SPIRA, ADAM PETER (PHD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:PETER
Last Name:SPIRA
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 1:624 N BROADWAY
Mailing Address - Street 2:HAMPTON HOUSE, RM 794
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-1900
Mailing Address - Country:US
Mailing Address - Phone:410-614-9498
Mailing Address - Fax:410-614-7469
Practice Address - Street 1:THE JOHNS HOPKINS OUTPATIENT CTR STE 1261
Practice Address - Street 2:601 N. CAROLINE STREET
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0001
Practice Address - Country:US
Practice Address - Phone:443-287-3313
Practice Address - Fax:443-287-3312
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04619103T00000X
CAPSY 21591103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist