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Individual

DR. RANDALL C HASTEDT

Active
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Individual

DR. RANDALL C HASTEDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35037545
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0552058
—
OH
05
—
0713197
—
OH
01
—
118238
ANTHEM BCBS
OH
01
—
220005334
RR MEDICARE
OH
Enumeration date
09/06/2005
Last updated
04/25/2013
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