Provider Demographics
NPI:1972768166
Name:VRADII, DIANA (MD)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:VRADII
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 1:8 MASON STREET
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-1514
Mailing Address - Country:US
Mailing Address - Phone:072-578-6608
Mailing Address - Fax:207-503-7534
Practice Address - Street 1:8 MASON STREET
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-1514
Practice Address - Country:US
Practice Address - Phone:072-578-6608
Practice Address - Fax:207-503-7534
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA237823207R00000X
NH33938207RR0500X
MEMD19657207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEE400111754Medicare PIN