Organization
SHIRLEY M. RANDALL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNETTE JOHN (OFFICE MANAGER)
(757) 483-7706
Entity
Organization
Contact information
Practice address
9507 HOSPITAL AVE, NASSAWADOX, VA 23413
(757) 414-8000
Mailing address
3105 AMERICAN LEGION RD, STE E, CHESAPEAKE, VA 23321-5654
(757) 483-7706
(757) 483-7726
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101034675
VA
Other
Enumeration date
11/07/2006
Last updated
04/20/2008
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