Radke, Frederick Roy

Radke, Frederick Roy is an individual health care provider with primary practice located at 887 Congress St Suite 400, Portland ME 04102-3100. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Radke, Frederick Roy can be contacted via phone (207) 774-6368.

Contact Information

Primary practice address
887 Congress St Suite 400 Portland ME 04102-3100
Phone: (207) 774-6368
Fax: (207) 662-7996
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD10664 Maine

Profile Details

NPI number 1144202953
LBN Legal business name Radke, Frederick Roy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2005
Last updated Nov 26th, 2014 - about 11 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 1144202953 NPPES
New Hampshire MEDICAID 30203950
New Hampshire Other P00384070
New Hampshire MEDICAID 113290099

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