Provider Demographics
NPI:1568201655
Name:RADER, CAITLIN (DO)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:RADER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LAKEWOOD FAMILY HEALTH CENTER
Mailing Address - Street 2:14601 DETROIT AVENUE
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107
Mailing Address - Country:US
Mailing Address - Phone:216-237-5500
Mailing Address - Fax:
Practice Address - Street 1:LAKEWOOD FAMILY HEALTH CENTER
Practice Address - Street 2:14601 DETROIT AVENUE
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107
Practice Address - Country:US
Practice Address - Phone:216-237-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program