Provider Demographics
NPI:1316965098
Name:RADER, JANET S (MD)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:S
Last Name:RADER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:GYNECOLOGIC ONCOLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-5660
Mailing Address - Fax:414-805-6622
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:GYNECOLOGIC ONCOLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-5660
Practice Address - Fax:414-805-6622
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO36510207VX0201X
WI53539207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1316965098Medicaid
IL036069925Medicaid
MO202838603Medicaid
WI736011539Medicaid
WI736011539Medicaid
WI68086 0811Medicare PIN
D13451Medicare UPIN
MO202838603Medicaid