Individual
DR. TABITHA MARTINEZ RANDOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4501 OLD SPARTANBURG RD, SUITE 9, TAYLORS, SC 29687-4105
(864) 292-8868
Mailing address
4501 OLD SPARTANBURG RD, SUITE 9, TAYLORS, SC 29687-4105
(864) 292-8868
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
27090
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270904
—
SC
Enumeration date
07/11/2006
Last updated
09/26/2022
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