Individual
ROBERT A RADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
402 W COUNTRY CLUB ROAD, ROSWELL, NM 88201
(575) 627-9500
(575) 627-9510
Mailing address
PO BOX 1574, ROSWELL, NM 88202
(575) 627-9500
(575) 627-9510
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
89280NM
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00020065NM
—
NM
01
—
1932187044
GROUP NPI
NM
01
—
800521089
MCR GROUP NUMBER
NM
01
—
Z2565
MCD GROUP NUMBER
NM
Enumeration date
04/11/2006
Last updated
12/26/2011
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