Provider Demographics
NPI:1588791040
Name:SPELLMAN, CYNTHIA (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:SPELLMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11921 FREEDOM DR
Mailing Address - Street 2:SUITE 550
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5667
Mailing Address - Country:US
Mailing Address - Phone:571-423-9282
Mailing Address - Fax:703-397-5175
Practice Address - Street 1:11921 FREEDOM DR
Practice Address - Street 2:SUITE 550
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5667
Practice Address - Country:US
Practice Address - Phone:571-423-9282
Practice Address - Fax:703-397-5175
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01057949A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry