Individual
DR. DERRICK WADE RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2145 HENRY TECKLENBURG DR STE 220, CHARLESTON, SC 29414-5894
(843) 723-8823
(843) 606-8059
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(888) 472-0043
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
050251
GA
207L00000X
Anesthesiology Physician
19659
SC
207LP2900X
Pain Medicine (Anesthesiology) Physician
19659
SC
208VP0000X
Pain Medicine Physician
Primary
19659
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000915967B
—
GA
01
—
19659
SC LICENSE
SC
05
—
196594
—
SC
Enumeration date
10/28/2005
Last updated
01/15/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us