Individual
DR. PAUL RAYMOND RADWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3506 SAN JOSE CT, PUEBLO, CO 81005-3916
(719) 252-6467
Mailing address
3506 SAN JOSE CT, PUEBLO, CO 81005-3916
(719) 252-6467
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20508
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02974278
—
CO
Enumeration date
06/02/2006
Last updated
02/27/2015
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