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Individual

DR. JOHN BYRNE RADEMAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3920 DUTCHMANS LN, LOUISVILLE, KY 40207-4702
(502) 259-6710
(502) 259-6704
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01046769
IN
207L00000X
Anesthesiology Physician
Primary
26478
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000064679
ANTHEM OF INDIANA
IN
01
000000064679
ANTHEM OF KENTUCKY
KY
01
050067688
RAILROAD MEDICARE
IN
01
1161027
PASSPORT
KY
01
129703800
BLACK LUNG PROGRAM
IN
01
134960B
UNICARE MEDICARE
IN
01
200024520
MANAGED HEALTH SERVICES
IN
05
200024520
IN
01
2439494000
PASSPORT ADVANTAGE
IN
05
64264781
KY
Enumeration date
09/07/2005
Last updated
12/08/2022
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