Individual
MRS. NADINE L RADWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9839
AZ
363AM0700X
Medical Physician Assistant
PA2188
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080143679
RR MEDICARE
—
05
—
11580534
—
CO
Enumeration date
04/24/2007
Last updated
09/07/2023
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