Provider Demographics
NPI:1306854682
Name:KADER, MICHAEL E (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:KADER
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 1:2080 CLINTON AVE SOUTH
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:585-271-2800
Mailing Address - Fax:585-271-0375
Practice Address - Street 1:2080 CLINTON AVE SOUTH
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-271-2800
Practice Address - Fax:585-271-0375
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235829207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP010235829OtherEXCELLUS
NYP020235829OtherEXCELLUS
NY000933816001OtherHEALTH NOW
NY9960147OtherAETNA
NYRC60235829OtherINDEPENDENT HEALTH/POMCO
NY02992450Medicaid
NY02992450Medicaid