Individual
MATTHEW CHET RADACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4402 SHIPYARD BLVD, WILMINGTON, NC 28403-6161
(910) 452-1400
(910) 332-1072
Mailing address
1202 MEDICAL CENTER DR, WILMINGTON, NC 28401-7307
(910) 341-3300
(910) 251-2067
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
9701118
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-28748
UNITED HEALTHCARE
NC
01
—
1072P
BCBS
NC
05
—
891072P
—
NC
01
—
930077046
RAILROAD MEDICARE
NC
01
—
930084659
RAILROAD MEDICARE
NC
01
—
B4555
MEDCOST
—
05
—
Q01118
—
SC
Enumeration date
06/14/2005
Last updated
03/17/2020
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