Spadafora, Suzanne Granados

Spadafora, Suzanne Granados is an individual health care provider with primary practice located at 301 Concourse Blvd Suite 190, Glen Allen VA 23059-5643. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Spadafora, Suzanne Granados can be contacted via phone (804) 549-4030.

Contact Information

Primary practice address
301 Concourse Blvd Suite 190 Glen Allen VA 23059-5643
Phone: (804) 549-4030
Fax: (804) 549-4032
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 0101234502 Virginia

Profile Details

NPI number 1912907650
LBN Legal business name Spadafora, Suzanne Granados
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2005
Last updated Jul 20th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912907650 NPPES
Virginia MEDICAID 010011001
Virginia Other 7455490
Virginia Other 0300593
Virginia Other 230864
Virginia Other P00044699
Virginia Other 266822

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