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General NPI Number Information
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NPI Number | 1669519625
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Entity Type | Organization
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Legal Business Name | EMANUEL H. RADER, P.S.C.
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 11/26/2007
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Provider Practice Location Address
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Address Line | 121 W VIRGINIA AVE SUITE C-100
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City | PINEVILLE
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State | KY
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Zip | 40977-1600
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Country | US
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Telephone | 606-337-3559
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Fax | 606-337-8252
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Provider Business Mailing Address
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Address Line | 121 W VIRGINIA AVE SUITE C-100
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City | PINEVILLE
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State | KY
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Zip | 40977-1600
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Country | US
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Telephone | 606-337-3559
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Fax | 606-337-8252
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Authorized Official
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Title or Position | OWNER
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Name | DR. EMANUEL H. RADER
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Credential | M.D.
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Telephone | 606-337-3570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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