Basic Information
| Provider Information | |||||||||
| NPI: | 1477728053 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RADU | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | DAWN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1431 CENTERPOINT BLVD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379321983 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655398000 | ||||||||
| FaxNumber: | 8655398008 | ||||||||
| Practice Location | |||||||||
| Address1: | 2018 W CLINCH AVE | ||||||||
| Address2: | DEPARTMENT OF EMERGENCY MEDICINE | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379162301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655418101 | ||||||||
| FaxNumber: | 8655418286 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2008 | ||||||||
| LastUpdateDate: | 04/24/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | ME93150 | FL | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0204X | MD44777 | TN | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Emergency Medicine | 2080P0204X | ME93150 | FL | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Emergency Medicine | 207P00000X | 44777 | TN | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.