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Individual
RANDALL NORMAN WILLARD
Active
Individual
RANDALL NORMAN WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
200400437
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1368Y
BCBS
NC
05
—
891368Y
—
NC
01
—
D7960
MEDCOST
NC
01
—
P00311531
RAILROAD MEDICARE
NC
05
—
Q0043G
—
SC
Enumeration date
06/13/2005
Last updated
11/24/2009
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