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Individual

SHAUN ANDREW SPADAFORA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8260 ATLEE RD, MECHANICSVILLE, VA 23116-1844
(804) 764-6000
Mailing address
8260 ATLEE RD, MECHANICSVILLE, VA 23116-1844
(804) 764-6000

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101238079
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1497732143
VA
01
186520
ANTHEM BCBS
VA
01
302011
ANTHEM
VA
01
4667482
CIGNA
VA
01
631591
SOUTHERN HEALTH
VA
01
P00130348
RR MEDICARE
VA
Enumeration date
12/23/2005
Last updated
02/19/2008
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