Radis, Charles D

Radis, Charles D is an individual health care provider with primary practice located at 51 Sewall St , Portland ME 04102-2643. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Radis, Charles D can be contacted via phone (207) 774-5761.

Contact Information

Primary practice address
51 Sewall St Portland ME 04102-2643
Fax: (207) 874-7478
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 1041 Maine

Profile Details

NPI number 1235122094
LBN Legal business name Radis, Charles D
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 26th, 2005
Last updated Aug 26th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235122094 NPPES
Maine Other 110116560 PALMETTOG RAILROAD MEDICARE
Maine Other 0673610001 PALMETTOG RAILROAD MEDICARE
Maine MEDICAID 115940199 PALMETTOG RAILROAD MEDICARE

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