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General NPI Number Information
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NPI Number | 1912907650
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Entity Type | Individual
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Provider Name | SUZANNE GRANADOS SPADAFORA MD
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Gender | Female
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Dates
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Enumeration Date | 07/22/2005
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 6946 FOREST AVE STE 200
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City | RICHMOND
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State | VA
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Zip | 23230-1706
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Country | US
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Telephone | 804-549-4040
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Fax | 804-549-4032
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Provider Business Mailing Address
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Address Line | 7201 GLEN FOREST DR STE 100
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City | RICHMOND
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State | VA
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Zip | 23226-3759
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Country | US
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Telephone | 804-549-4030
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Fax | 804-549-4032
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 0101234502
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License Number State | VA
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