| Name: | David L. Rader, M.D., P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 05 Oct 1992 (32 years ago) |
| Entity Number: | 000-152-490 |
| Register Number: | 000152490 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 2700 9TH COURT SOUTH STE 500BIRMINGHAM, AL 35205 |
| Registered Office Street Address ZIP Code: | 35205 |
| Authorized Capital: | $100 |
| Paid Share Capital: | $100 |
Activities
PRACTICE MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760541635 | 2006-12-07 | 2020-08-22 | 833 SAINT VINCENTS DR, SUITE 202, BIRMINGHAM, AL, 352051606, US | 833 SAINT VINCENTS DR, SUITE 202, BIRMINGHAM, AL, 352051606, US | |||||||||||||||||||||||||
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| Phone | +1 205-933-8150 |
| Fax | 2055584064 |
Authorized person
| Name | DAVID L RADER |
| Role | OWNER |
| Phone | 2059338150 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| License Number | 11987 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PROVIDER NUMBER |
| Number | 51084730 |
| State | AL |
| Name | Role |
|---|---|
| RADER, DAVID L | Agent |
| Name | Role |
|---|---|
| RADER, DAVID L | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
