Provider Demographics
NPI:1871797936
Name:SPENCER, LORI A (MD PHD)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:A
Last Name:SPENCER
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:537 STANTON CHRISTIANA RD
Mailing Address - Street 2:SUITE #207
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713
Mailing Address - Country:US
Mailing Address - Phone:302-633-7550
Mailing Address - Fax:302-225-3774
Practice Address - Street 1:537 STANTON CHRISTIANA RD
Practice Address - Street 2:SUITE #207
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713
Practice Address - Country:US
Practice Address - Phone:302-633-7550
Practice Address - Fax:302-225-3774
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC10008690207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology