Individual
DR. FELICIA R. RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2888 W GRAND BLVD, DETROIT, MI 48202-2612
(313) 875-5377
(313) 875-5727
Mailing address
2700 HAMLIN BLVD, INKSTER, MI 48141-2206
(313) 561-5100
(313) 561-5100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301074153
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4583949
—
MI
Enumeration date
07/15/2005
Last updated
09/24/2018
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