Individual
DR. MICHAEL G RADLEY
Active
Individual
DR. MICHAEL G RADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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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