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General NPI Number Information
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NPI Number | 1003002585
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Entity Type | Organization
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Legal Business Name | MICHAEL P RADE MD PC
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 550 CENTER RD
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City | WEST SENECA
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State | NY
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Zip | 14224-2128
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Country | US
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Telephone | 716-675-1414
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Fax |
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Provider Business Mailing Address
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Address Line | 550 CENTER RD
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City | WEST SENECA
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State | NY
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Zip | 14224-2128
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Country | US
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Telephone | 716-675-1414
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL RADE
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Credential | MD
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Telephone | 716-675-1414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 128302-1
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License Number State | NY
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