Individual
MS. CYNTHIA RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.C.
Contact information
Practice address
12547 OCEAN GATEWAY, OCEAN CITY, MD 21842-9341
(410) 213-0119
(410) 213-2875
Mailing address
12547 OCEAN GATEWAY, OCEAN CITY, MD 21842-9341
(410) 213-0119
(410) 213-2875
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0002701
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1032642
P.A.C. CERTIFICATION
MD
01
—
C0002701
P.A, LICENSE
MD
01
—
C5-0000497
P.A. LICENSE
DE
01
—
PA0202
PRESCRIBE NARCOTICS
DE
01
—
PA55377
LICENSE TO PRESCRIBE CONT
MD
Enumeration date
11/24/2006
Last updated
03/07/2023
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