Individual
RANDOLPH J CORDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-2171
(704) 355-5736
Mailing address
PO BOX 601372, CHARLOTTE, NC 28260-1372
(704) 355-2171
(704) 355-5736
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01041556A
IN
207P00000X
Emergency Medicine Physician
Primary
2005-01146
NC
207P00000X
Emergency Medicine Physician
200501146
NC
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
2005-01146
NC
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
2005-01146
NC
2085U0001X
Diagnostic Ultrasound Physician
2005-01146
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140JJ
NCBCBS
NC
05
—
5900951
—
NC
05
—
N46005
—
SC
Enumeration date
07/03/2006
Last updated
11/03/2022
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