| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MARTIN RANDALL | 1992328330 | 2023-05-07 |
Martin Randall is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1992328330. Registration indicates Martin Randall is a provider of access to pediatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, Pediatrics (Allopathic & Osteopathic Physicians, Pediatrics) (Pediatrics, ) (Primary Care/Family Planning/APRN/PA, ) (Pediatrics, Allopathic & Osteopathic Physicians)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Dr. Martin Randall MD |
| Practice Office Address | 13699 E. OLD US HIGHWAY 12 CHLESEA, MI US |
| Practice Office Telephone | 7344754500 |
| Practice Office Fax | 7344754507 |
| Mailing Address | 13699 E. OLD US HIGHWAY 12 CHLESEA, MI 48118 US |
| Business Telephone | 7344754500 |
| Business Fax | 7344754507 |
| Code | Practice | License No State |
|---|---|---|
| 208000000X PRIMARY | Access to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Pediatrics Allopathic & Osteopathic Physicians Pediatrics Pediatrics Primary Care/Family Planning/APRN/PA Pediatrics Allopathic & Osteopathic Physicians | 4301509245
MI |