Provider Demographics
NPI:1316137714
Name:SPANGLER, MARION LEE II (MD)
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:LEE
Last Name:SPANGLER
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2722 MERRILEE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4420
Mailing Address - Country:US
Mailing Address - Phone:703-698-4444
Mailing Address - Fax:703-204-0116
Practice Address - Street 1:2722 MERRILEE DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4420
Practice Address - Country:US
Practice Address - Phone:703-698-4444
Practice Address - Fax:703-204-0116
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012535262085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
9891703OtherAETNA -- NON HMO
VA540846558OtherPHCS - MULTPLAN
VA1316137714Medicaid
WV3810020392Medicaid
VA8972897OtherAETNA HMO
0133OtherCAREFIRST BCBS NCA
328509OtherKAISER
VA75733OtherAMERIGROUP
VAVV9977AMedicare PIN
9891703OtherAETNA -- NON HMO