Provider Demographics
NPI:1780277699
Name:JABER, RADEE
Entity type:Individual
Prefix:
First Name:RADEE
Middle Name:
Last Name:JABER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 CENTRE GREEN WAY # 3000
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-2283
Mailing Address - Country:US
Mailing Address - Phone:865-748-2744
Mailing Address - Fax:
Practice Address - Street 1:1000 CENTRE GREEN WAY # 3000
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2283
Practice Address - Country:US
Practice Address - Phone:865-748-2744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN330101051140607183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician