MEDICARE: JAMES R RADEMACHER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	26886	SC
2	207W00000X	Ophthalmology Physician	35089288	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00127042	OTHER	SC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20036127	OTHER	SC	SELECT HEALTH
2	9624212	OTHER	SC	GHI
3	7439590	OTHER	SC	AETNA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669475133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES R RADEMACHER M.D.

Provider Business Mailing Address
First Line	:	4445 LAKE FOREST DR STE 600
Second Line	:
City	:	BLUE ASH
State	:	OH
Zip	:	45242-3744
Country	:	US
Telephone Number	:	513-515-6172
Fax Number	:	937-335-6684

Provider Business Practice Location Address
First Line	:	180 S STANFIELD RD
Second Line	:
City	:	TROY
State	:	OH
Zip	:	45373-0106
Country	:	US
Telephone Number	:	937-335-9020
Fax Number	:	937-335-6684

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	09/16/2020

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