Organization
MICHELLE RANDOLPH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE LISA RANDOLPH MD (PRESIDENT)
(808) 295-6058
Entity
Organization
Contact information
Practice address
2741 DEBARR ROAD SUITE 402, ANCHORAGE, AK 99508
(907) 531-5213
(907) 531-5013
Mailing address
2741 DEBARR ROAD SUITE 402, ANCHORAGE, AK 99508
(907) 531-5213
(907) 531-5013
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
7641
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1583849
—
AK
Enumeration date
03/29/2013
Last updated
10/28/2020
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