Andrew Spencer

Individual provider Active NPI Contractor · Bluffton, SC

NPI 1194179986 · NPPES record last updated Apr 18, 2016

Key facts

NPI
1194179986
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
Practice address
29 Plantation Park Dr
Bluffton, SC 29910-9001
Phone
(843) 298-4320
NPI assigned
Apr 18, 2016
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Autism Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Yes

Addresses

Primary practice location

29 Plantation Park Dr
Bluffton, SC 29910-9001

Mailing address

PO Box 3444
Bluffton, SC 29910-3444
Phone (843) 298-4320

Other providers in Bluffton, SC

All providers in Bluffton, SC · Contractor in South Carolina

Sources for this page

Verify at the official NPI Registry.