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Individual

SHIRLEY REGINA MASON-RANDALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4364 LANKFORD HWY, EXMORE, VA 23350-2308
(757) 656-3465
Mailing address
2987 BUTLERS BLUFF DR, CAPE CHARLES, VA 23310-1429
(757) 331-2022

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101034675
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5708001
VA
Enumeration date
10/20/2005
Last updated
07/24/2015
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