Individual
MR. RANDALL DAVID WILHOIT IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-8667
Mailing address
2515 GUILFORD AVE, BALTIMORE, MD 21218-4619
(864) 201-5927
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
R210020
MD
363L00000X
Nurse Practitioner
Primary
5013068
NC
363LA2100X
Acute Care Nurse Practitioner
R210020
MD
Other
Enumeration date
09/27/2017
Last updated
07/27/2020
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