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NPI Code Detail

MEDICARE: SHAUN ANDREW SPADAFORA MD

MEDICARE: SHAUN ANDREW SPADAFORA MD
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
1207R00000XInternal Medicine Physician0101238079VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
6P00130348OTHERVARR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1186520OTHERVAANTHEM BCBS
2302011OTHERVAANTHEM
34667482OTHERVACIGNA
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5631591OTHERVASOUTHERN HEALTH

General Provider Information

NPI Number : 1497732143
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAUN ANDREW SPADAFORA MD
Provider Business Mailing Address
First Line : 8260 ATLEE RD
Second Line :
City : MECHANICSVILLE
State : VA
Zip : 23116-1844
Country : US
Telephone Number : 804-764-6000
Fax Number :
Provider Business Practice Location Address
First Line : 8260 ATLEE RD
Second Line :
City : MECHANICSVILLE
State : VA
Zip : 23116-1844
Country : US
Telephone Number : 804-764-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2005
Last Update Date : 02/19/2008

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