Provider Demographics
NPI:1477728053
Name:RADU, HEATHER DAWN (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:DAWN
Last Name:RADU
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 1:1431 CENTERPOINT BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-1983
Mailing Address - Country:US
Mailing Address - Phone:865-539-8000
Mailing Address - Fax:865-539-8008
Practice Address - Street 1:2018 W CLINCH AVE
Practice Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2301
Practice Address - Country:US
Practice Address - Phone:865-541-8101
Practice Address - Fax:865-541-8286
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME93150208000000X, 2080P0204X
TNMD447772080P0204X
TN44777207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine