Provider Demographics
NPI:1285611673
Name:SPOMER, AMY B
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:B
Last Name:SPOMER
Suffix:
Gender:F
Credentials:
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6465 WAYZATA BLVD
Mailing Address - Street 2:STE 315
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1728
Mailing Address - Country:US
Mailing Address - Phone:952-993-7169
Mailing Address - Fax:952-993-0300
Practice Address - Street 1:6490 EXCELSIOR BLVD STE W01
Practice Address - Street 2:PARK NICOLLET CLINIC - MEAD
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426
Practice Address - Country:US
Practice Address - Phone:952-993-3248
Practice Address - Fax:952-993-2810
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2011-10-06
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Provider Licenses
StateLicense IDTaxonomies
MN38755207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology