Individual
RANDY C MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
224 W DL INGRAM AVENUE, BUILDING 1408, CANNON AFB, NM 88103
(575) 784-2778
Mailing address
224 W DL INGRAM AVENUE, BUILDING 1408, CANNON AFB, NM 88103
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DO2024-0053
NM
Other
Enumeration date
04/06/2020
Last updated
08/14/2024
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