Provider Demographics
NPI:1669032959
Name:SPADARO, JANE ZHU
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:ZHU
Last Name:SPADARO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:YAN
Other - Middle Name:
Other - Last Name:ZHU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHARMD
Mailing Address - Street 1:39000 7 MILE RD STE 2400
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1006
Mailing Address - Country:US
Mailing Address - Phone:248-800-1177
Mailing Address - Fax:
Practice Address - Street 1:39000 7 MILE RD STE 2400
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1006
Practice Address - Country:US
Practice Address - Phone:248-800-1177
Practice Address - Fax:248-800-1178
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2023-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301508434207W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty