Individual
GAYLE JORDAN-RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
920 SAINT PAUL ST APT 2, BALTIMORE, MD 21202-6512
(410) 727-4663
Mailing address
920 SAINT PAUL ST, SUITE 2, BALTIMORE, MD 21202-2423
(410) 727-4663
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
D44078
MD
2084P0800X
Psychiatry Physician
D44078
MD
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
D44078
MD
Other
Enumeration date
12/20/2011
Last updated
12/20/2011
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