Healthcare Provider Details

I. General information

NPI: 1952321333
Provider Name (Legal Business Name): MEGAN CHRISTINE RADER RD,LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 05/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9030 MONTGOMERY RD
CINCINNATI OH
45242-7741
US

IV. Provider business mailing address

8598 KEMPTON LN
MAINEVILLE OH
45039-7518
US

V. Phone/Fax

Practice location:
  • Phone: 513-505-6800
  • Fax:
Mailing address:
  • Phone: 614-354-2126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number5464
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: