MEDICARE: ADRIANA SPANOVA 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
1	207Q00000X	Family Medicine Physician	L2758	AL
2	207Q00000X	Family Medicine Physician	01066620A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548470131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANA SPANOVA MD

Provider Business Mailing Address
First Line	:	PO BOX 890631
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28289-0631
Country	:	US
Telephone Number	:	812-949-5482
Fax Number	:	812-948-6715

Provider Business Practice Location Address
First Line	:	3605 NORTHGATE CT
Second Line	:	SUITE 209
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-6400
Country	:	US
Telephone Number	:	812-941-9355
Fax Number	:	812-941-9312

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	12/03/2020

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Directions to “ ADRIANA SPANOVA MD” Practice Location

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