Individual
DR. WILLIAM ALAN RADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4202 MACCORKLE AVE SE, CHARLESTON, WV 25304-2502
(304) 925-4761
Mailing address
4202 MACCORKLE AVE SE, CHARLESTON, WV 25304-2502
(304) 925-4761
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
774-OD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720471
BLUE CROSS BLUE SHIELD
WV
05
—
0149325000
—
WV
01
—
0621280001
ADMINISTAR
WV
01
—
4320198
AETNA
WV
Enumeration date
09/22/2006
Last updated
11/10/2014
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