Provider Demographics
NPI:1871740597
Name:SPAHALSKI, BERNARD MARK (HEARING INSTR SPEC)
Entity type:Individual
Prefix:
First Name:BERNARD
Middle Name:MARK
Last Name:SPAHALSKI
Suffix:
Gender:M
Credentials:HEARING INSTR SPEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 US 31 S STE F
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-3563
Mailing Address - Country:US
Mailing Address - Phone:317-882-1030
Mailing Address - Fax:
Practice Address - Street 1:88 US 31 S STE F
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-3563
Practice Address - Country:US
Practice Address - Phone:317-882-1030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN40002345A237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist