Individual
DAVID E RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1447 N HARRISON ST, SAGINAW, MI 48602-4727
(989) 583-6000
Mailing address
1447 N HARRISON ST, SAGINAW, MI 48602-4727
(989) 583-6000
(989) 466-3633
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
4301056391
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4863405
—
MI
01
—
CA2184
RAILROAD MEDICARE
MI
Enumeration date
05/19/2006
Last updated
11/20/2019
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