Individual
DONNA D RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2603 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-5110
(651) 600-3035
Mailing address
2603 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-5110
(651) 600-3035
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
39856
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
742977100
—
MN
Enumeration date
07/03/2006
Last updated
11/05/2019
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