Provider Demographics
NPI:1356367171
Name:RADOW, SCOTT K (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:K
Last Name:RADOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1000 BOULDERS PKWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-5545
Mailing Address - Country:US
Mailing Address - Phone:804-320-4243
Mailing Address - Fax:804-282-1486
Practice Address - Street 1:6600 W BROAD ST STE 300
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1709
Practice Address - Country:US
Practice Address - Phone:804-320-4243
Practice Address - Fax:804-622-0552
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101030196207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4800226OtherUNITED HEALTHCARE PROV #
VA80058OtherSOUTHERN HEALTH PROVIDER#
VA005812330Medicaid
VA021789OtherCIGNA
VA189594OtherANTHEM PROVIDER NUMBER
NJ0175056Medicaid
VA557515OtherAETNA PROVIDER NUMBER
VA22019OtherCARENET
VA22019OtherCARENET
VA006895400OtherBLACK LUNGPROVIDER NUMBER