Provider Demographics
NPI:1932138658
Name:RADER, GALINA BORISOVNA (MD)
Entity type:Individual
Prefix:DR
First Name:GALINA
Middle Name:BORISOVNA
Last Name:RADER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4274 LAKESHORE LN UNIT 200
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-7081
Mailing Address - Country:US
Mailing Address - Phone:423-716-1611
Mailing Address - Fax:
Practice Address - Street 1:4274 LAKESHORE LN UNIT 200
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-7081
Practice Address - Country:US
Practice Address - Phone:423-716-1611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37680207QH0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1508310Medicaid
TN3387327Medicare ID - Type Unspecified