Provider Demographics
NPI:1023123247
Name:RADEMACHER, DAVID HOLBEIN (MA)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:HOLBEIN
Last Name:RADEMACHER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 BRANCH ST
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-1414
Mailing Address - Country:US
Mailing Address - Phone:919-542-1726
Mailing Address - Fax:
Practice Address - Street 1:35 THOMPSON ST STE 205
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-5653
Practice Address - Country:US
Practice Address - Phone:919-542-1726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4368101YM0800X
NC1642103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6107016Medicaid
NC1335JOtherBLUE CROSS