Individual
DR. RANDALL C HASTEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
793 W STATE ST, MT. CARMEL WEST HOSPITAL PATHOLOGY DEPT., COLUMBUS, OH 43222-1551
(614) 234-1300
(614) 234-2931
Mailing address
PO BOX 20452, COPA-CRED, COLUMBUS, OH 43220-0452
(614) 888-7874
(614) 442-2410
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35037545
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0552058
—
OH
05
—
0713197
—
OH
01
—
118238
ANTHEM BCBS
OH
01
—
220005334
RR MEDICARE
OH
Enumeration date
09/06/2005
Last updated
04/25/2013
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