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Individual

KEVIN M RADECKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5965 E BROAD ST, SUITE 340, COLUMBUS, OH 43213-1562
(614) 234-7505
(614) 234-7506
Mailing address
PO BOX 650, BLACKLICK, OH 43004-0650
(614) 234-7505
(614) 234-7506

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
35079805
OH
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
D0063316
MD

Other

Enumeration date
07/20/2005
Last updated
04/24/2008
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