Provider Demographics
NPI:1114959525
Name:RADUEGE, WILLIAM E (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:RADUEGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4348 COUNTY ROAD B
Mailing Address - Street 2:UNIT B
Mailing Address - City:LAND O LAKES
Mailing Address - State:WI
Mailing Address - Zip Code:54540-9635
Mailing Address - Country:US
Mailing Address - Phone:715-547-6118
Mailing Address - Fax:
Practice Address - Street 1:4348 COUNTY ROAD B
Practice Address - Street 2:UNIT B
Practice Address - City:LAND O LAKES
Practice Address - State:WI
Practice Address - Zip Code:54540-9635
Practice Address - Country:US
Practice Address - Phone:715-547-6118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15982207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31144200Medicaid
WI005939315Medicare Oscar/Certification
WI000964050Medicare Oscar/Certification
WI31144200Medicaid