Individual
RANDALL PROVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
98 DOCTORS DR, SUITE 200, SYLVA, NC 28779-4501
(828) 586-8971
(828) 586-4083
Mailing address
98 DOCTORS DR, STE 200, SYLVA, NC 28779-4501
(828) 586-8971
(828) 586-4083
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
32835
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7969355
—
NC
Enumeration date
04/28/2006
Last updated
09/04/2012
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