Paul Raymond Radway, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

20508 Issued in CO

Practice address

3506 San Jose CT
Pueblo, CO 81005-3916

Phone

(719) 252-6467

NPI assigned

Jun 2, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Surgical Consultants of Pueblo, PC

  • Surgery Physician
  • Pueblo, CO
  • NPI 1841339447
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424995200000",
    "number": "1023056173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3506 SAN JOSE CT",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810053916",
            "telephone_number": "719-252-6467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3506 SAN JOSE CT",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810053916",
            "telephone_number": "719-252-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADWAY",
        "first_name": "PAUL",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2015-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "20508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02974278",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianna Rabjohns, MS
• Laura Racy
• Sofyan Morshed Taleb Radaideh, MD
• Sabrina Nicole Radiff
• Radiology Associates
• Alexis Marie Rael
• Gregory Ragulsky
• Ronald James Ragulsky, D.D.S.,L.L.C
• Gina Marie Raigoza, MBA
• Somasundaram Rajendran, M.D.

• Surgery Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.