Individual
DR. DAVID M. RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5900 LAKE WRIGHT DR STE B, NORFOLK, VA 23502-1871
(757) 213-5770
(757) 627-0334
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 213-5770
(757) 627-0334
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
0101 036962
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10035953
SENTARA/OPTIMA
VA
01
—
10259
BC/BS
NC
05
—
1447216866
—
VA
01
—
359100
ANTHEM
VA
05
—
5910259
—
NC
01
—
6181967
UHC/MAMSI
VA
01
—
9841062
CIGNA
VA
01
—
PAR
USA MANAGED CARE
VA
Enumeration date
04/25/2006
Last updated
04/07/2009
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