Individual
MR. MARC D RADABAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1027 BELLEVUE AVE STE 107, RICHMOND HEIGHTS, MO 63117-1851
(314) 645-3743
(314) 647-7967
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(314) 851-1000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11019421A
IN
207Q00000X
Family Medicine Physician
Primary
2021034961
MO
207R00000X
Internal Medicine Physician
11019421A
IN
207R00000X
Internal Medicine Physician
2021034961
MO
Other
Enumeration date
04/03/2017
Last updated
08/30/2021
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