Individual
DR. RANDOLPH AUGUSTUS MALONE IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
060041
—
174400000X
Specialist
—
—
207KA0200X
Allergy Physician
Primary
034412
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000465671A
—
GA
Enumeration date
02/01/2006
Last updated
03/17/2018
Update your record
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