Individual
DR. ROBERT D RANDALL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1665 HERLONG CT, SUITE A, ROCK HILL, SC 29732-1193
(803) 329-8500
(803) 329-8511
Mailing address
1665 HERLONG CT, SUITE A, ROCK HILL, SC 29732-1193
(803) 329-8500
(803) 329-8511
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
10864
SC
208600000X
Surgery Physician
20949
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108644
—
SC
01
—
2073882
FIRST HEALTH
—
01
—
297388
MAMSI
—
Enumeration date
06/16/2005
Last updated
10/29/2009
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