Sponaugle, Dale W

Sponaugle, Dale W is an sole proprietor health care provider with primary practice located at 200 Ohio St , Medina NY 14103-1063. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Sponaugle, Dale W can be contacted via phone (585) 798-8054.

Contact Information

Primary practice address
200 Ohio St Medina NY 14103-1063
Phone: (585) 798-8054
Fax: (585) 798-8150
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 164356 New York

Profile Details

NPI number 1023018462
LBN Legal business name Sponaugle, Dale W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 28th, 2005
Last updated Aug 30th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023018462 NPPES
New York Other 000525331009 BCBS WNY
New York Other 201590500 BCBS WNY
New York Other P010164356 BCBS WNY
New York Other 020382600 BCBS WNY
New York Other 040403006845 BCBS WNY
New York Other 117837FF BCBS WNY
New York Other 00020548502 BCBS WNY
New York MEDICAID 01257134 BCBS WNY
New York Other 5690902 BCBS WNY
New York Other 164356 BCBS WNY

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