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Individual

MR. RANDOLPH C FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CERTIFIED PEDORTHIST

Contact information

Practice address
443 DANIELS ST, RALEIGH, NC 27605-1359
(919) 833-4848
(919) 833-4648
Mailing address
1411 SACHEM PL UNIT 3, CHARLOTTESVILLE, VA 22901-2556
(434) 975-5434
(434) 975-0081

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CPED1572
AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS AND PEDORTHICS, INC
NC
Enumeration date
07/01/2008
Last updated
07/01/2008
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