Provider Demographics
NPI:1609816461
Name:RADEMACHER, PEDRO RICARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:RICARDO
Last Name:RADEMACHER
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 1:4435 AICHOLTZ RD
Mailing Address - Street 2:STE 800 C
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-1690
Mailing Address - Country:US
Mailing Address - Phone:513-688-1500
Mailing Address - Fax:513-753-2472
Practice Address - Street 1:4435 AICHOLTZ RD
Practice Address - Street 2:STE 800 C
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1690
Practice Address - Country:US
Practice Address - Phone:513-688-1500
Practice Address - Fax:513-753-2472
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-063313207RN0300X
KY29055207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200070190Medicaid
KY64290554Medicaid
OH0703242Medicaid
E86006Medicare UPIN
OH0703242Medicaid
OH0679866Medicare PIN