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NPI Code Detail

MEDICARE: MRS. GINNIE MARIE SPADAFORE-BARRETT PA-C

MEDICARE:  MRS. GINNIE MARIE SPADAFORE-BARRETT  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant5601004186MI

General Provider Information

NPI Number : 1265407530
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GINNIE MARIE SPADAFORE-BARRETT PA-C
Provider Business Mailing Address
First Line : 1501 N MILFORD RD STE 200
Second Line :
City : MILFORD
State : MI
Zip : 48381-1049
Country : US
Telephone Number : 482-717-0585
Fax Number : 248-717-0845
Provider Business Practice Location Address
First Line : 2455 UNION LAKE RD STE 101
Second Line :
City : COMMERCE TOWNSHIP
State : MI
Zip : 48382-3596
Country : US
Telephone Number : 248-363-2239
Fax Number : 248-363-3517
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2006
Last Update Date : 12/15/2025

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Directions to “ MRS. GINNIE MARIE SPADAFORE-BARRETT PA-C” Practice Location

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