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General NPI Number Information
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NPI Number | 1265538979
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Entity Type | Individual
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Provider Name | PAUL THOMAS SPADA D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 10/10/2012
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Provider Practice Location Address
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Address Line | 533 RODNEY LN
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-2227
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Country | US
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Telephone | 757-560-9388
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Fax | 757-523-9476
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Provider Business Mailing Address
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Address Line | 533 RODNEY LN
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-2227
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Country | US
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Telephone | 757-560-9388
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Fax | 757-523-9476
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 0103000983
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | SC0032299L
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License Number State | PA
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