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Individual

ANDREW JAMES RADER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
645 W 5TH ST, JASPER, IN 47546-3172
(812) 634-2778
(812) 634-2909
Mailing address
645 W 5TH ST, JASPER, IN 47546-3172
(812) 634-2778

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000700
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
07000700
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000306119
ANTHEM
IN
05
100110820
IN
Enumeration date
07/14/2006
Last updated
10/01/2024
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