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SPENCER D GREENDYKE MD LLC NPI 1558468439


NPI Information

NPI: 1558468439
Provider Name: SPENCER D GREENDYKE MD LLC

Doing Business As: RIVERSEDGE ORTHOPEDICS

Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
3318 N GRAND MILL LN
COEUR D'ALENE, ID
ZIP 83814
Phone: (208) 277-1060
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SPENCER D GREENDYKE MD LLC is a medical specialty clinic center in Coeur D'alene, ID. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). SPENCER D GREENDYKE MD LLC NPI is 1558468439. The provider is registered as an organization entity type.
The provider Is Doing Business As Riversedge Orthopedics.

The provider's business location address is:

3318 N GRAND MILL LN
COEUR D'ALENE, ID
ZIP 83814
Phone: (208) 277-1060
Fax: (208) 277-1065

The provider's authorized official is Spencer D Greendyke .
The authorized official title is Physician and has the following contact phone number (208) 277-1060.

The enumeration date for this NPI number is 9/20/2006 and was last updated on 2/24/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM2500XClinic/CenterMedical SpecialtyM9110IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G32071MEDICARE UPINIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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