Individual
RUSSELL GLYN RADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
703 MCEWAN, CLARE, MI 48617
(989) 802-8875
(989) 802-8866
Mailing address
9975 TIMBER RIDGE RD, FARWELL, MI 48622
(989) 802-8875
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704143484
MI
Other
Enumeration date
05/23/2006
Last updated
07/09/2007
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