Individual
DR. MICHAEL G RADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17 WESTERN MARYLAND PKWY, HAGERSTOWN, MD 21740-5146
(301) 797-9240
(301) 797-4119
Mailing address
20310 COTTONWOOD DR, HAGERSTOWN, MD 21742-4020
(301) 733-4232
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
D0045936
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140005761
RR MEDICARE
—
01
—
436164
PA BLUE SHIELD MD LOC
PA
01
—
53220504
MD BLUE SHIELD TRADITIONA
MD
05
—
597381300
—
MD
01
—
966246
PA BLUE SHIELD PA LOC
PA
01
—
W2660003
MD BLUE SHIELD REGIONAL
MD
Enumeration date
07/20/2006
Last updated
08/31/2012
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