Organization
WILLIAM E. RANDALL, JR., M.D. P.A.
Active
Organization
WILLIAM E. RANDALL, JR., M.D. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM EDDY RANDALL JR. M.D. (OWNER)
(410) 823-1313
Entity
Organization
Contact information
Practice address
1205 YORK RD, SUITE 33, LUTHERVILLE, MD 21093-6210
(410) 823-1313
(410) 823-1316
Mailing address
1205 YORK RD, SUITE 33, LUTHERVILLE, MD 21093-6210
(410) 823-1313
(410) 823-1316
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
D0015808
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003951900
—
MD
01
—
06372
AMERIGROUP
—
01
—
34794001
BLUE SHIELD
—
01
—
4070033
AETNA
—
01
—
443218
AMERIHEALTH
—
01
—
E181
FEDERAL BS
—
Enumeration date
11/05/2009
Last updated
01/10/2010
Update your record
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