Provider Demographics
NPI:1720718307
Name:CHAMBERS, SPENCER BRIAN (MD,MSC,BENG)
Entity type:Individual
Prefix:MR
First Name:SPENCER
Middle Name:BRIAN
Last Name:CHAMBERS
Suffix:
Gender:M
Credentials:MD,MSC,BENG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 GROSVNER STREET ST. JOSEPH'S HEALTHCARE
Mailing Address - Street 2:ROOM D1-201 C/O AMANDA CLOSE
Mailing Address - City:LONDON
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N6A 4V2
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:268 GROSVENOR STREET ST. JOSEPH'S HEALTHCARE
Practice Address - Street 2:ROOM D1-201 C/O AMANDA CLOSE
Practice Address - City:LONDON
Practice Address - State:ONTARIO
Practice Address - Zip Code:N6A 4V2
Practice Address - Country:CA
Practice Address - Phone:519-646-6326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ112833390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program