Individual
DR. WILLIAM SALVATOR RANDAZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1269
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
29669
SC
2080A0000X
Pediatric Adolescent Medicine Physician
25MA04387300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201940413
TAX ID
NJ
05
—
296699
—
SC
Enumeration date
08/08/2006
Last updated
10/22/2020
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