Individual
BARRY A RADIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1245 15TH ST N, SAINT CLOUD, MN 56303-1802
(320) 253-5200
(320) 203-2113
Mailing address
1511 NORTHWAY DR, STE 103, SAINT CLOUD, MN 56303-1262
(320) 267-1341
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8819
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
512636300
—
MN
Enumeration date
02/17/2006
Last updated
10/15/2020
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