Most Relevant Information
Provider Data
| NPI Number: | 1003056433 |
| Provider Name: | KEITH MICHAEL SPELLMAN M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 2085R0202X |
| Specialty: | Radiology |
| License Number: | A107892 |
Most Important Dates
| Enumeration Date: | 02/25/2009 |
| Last Updated: | 11/26/2013 |
Provider Practice Location
201 LYONS AVE
NEWARK
NJ
071122027
Practice Location Phone/Fax
| Phone: | 9739267960 |
| Fax: |
Provider Mailing Location
148 BEACHVIEW AVE
SANTA CRUZ
CA
950603008
Provider Mailing Phone/Fax
| Phone: | 2155202318 |
| Fax: |