Individual
MAURICE B RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
11020 HULL STREET RD, MIDLOTHIAN, VA 23112-3200
(804) 744-6310
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110004100
VA
Other
Enumeration date
10/24/2012
Last updated
03/14/2022
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