Individual
MICHAEL DAVID RADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1121 W 3RD ST, ELK CITY, OK 73644-5103
(580) 243-3376
(580) 243-3377
Mailing address
1121 W 3RD ST, ELK CITY, OK 73644-5103
(580) 243-3376
(580) 243-3377
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
18832
OK
207NP0225X
Pediatric Dermatology Physician
18832
OK
207NS0135X
Procedural Dermatology Physician
18832
OK
Other
Enumeration date
10/18/2005
Last updated
10/24/2008
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