Provider Demographics
NPI:1487618500
Name:SPIELMANN, D. GEOFFREY (MD)
Entity type:Individual
Prefix:
First Name:D.
Middle Name:GEOFFREY
Last Name:SPIELMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 E. KINCAID ST.
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4127
Mailing Address - Country:US
Mailing Address - Phone:360-428-2500
Mailing Address - Fax:360-428-6485
Practice Address - Street 1:1415 E. KINCAID ST.
Practice Address - Street 2:SKAGIT VALLEY HOSPITAL
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4126
Practice Address - Country:US
Practice Address - Phone:360-416-5750
Practice Address - Fax:360-416-4758
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00033443208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA263781OtherLABOR & INDUSTRIES
WA8186272Medicaid
WAAB21980Medicare ID - Type Unspecified
WAA88609Medicare UPIN
A88609Medicare UPIN
WA8186272Medicaid