Provider Demographics
NPI:1750354296
Name:SPINELLI, ANTHONY W (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:W
Last Name:SPINELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 197
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16804-0197
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:434-244-4579
Practice Address - Street 1:500 MARTHA JEFFERSON DR
Practice Address - Street 2:CHARLOTTESVILLE RADILOGY
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-4668
Practice Address - Country:US
Practice Address - Phone:434-244-4580
Practice Address - Fax:434-244-4579
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012306782085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007233019Medicaid
VA300123076OtherRRMED
VA007233019Medicaid
VA300123076OtherRRMED