Individual
JAMES KENT RADIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
825 FAIRFAX AVE, STE 572, NORFOLK, VA 23507-1914
(757) 446-8999
(757) 446-7922
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 446-8999
(757) 446-7922
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
0101044290
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619948833
USA MANAGED CARE
VA
01
—
1619948833
CORVEL
—
05
—
1619948833
—
VA
Enumeration date
01/27/2006
Last updated
06/09/2017
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