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Individual
JERRY LEE RADAS
Active
Individual
JERRY LEE RADAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
SO1592
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M123JL
CAREFIRST BCBS
MD
01
—
W3530001
CAREFIRST BCBS
—
Enumeration date
09/29/2006
Last updated
01/25/2011
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