Christa Dawn Randolph in Bridgeport - Specialist
Christa Dawn Randolph - NPI 1174508121
Christa Dawn Randolph is a Specialist in Bridgeport, . Christa Dawn Randolph practices all healthcare services and medical treatments related to Specialist. The NPI Number for Christa Dawn Randolph is 1174508121. The last update date is 2012-07-12.
Christa Dawn Randolph's current location address is 306 W Main St, Bridgeport, . You can contact this provider via phone number 3048423137 and fax number 3048423138. The mailing address for Christa Dawn Randolph is 306 W Main St, Bridgeport, . To know further, please read the information below!
Provider Profile Detail
| Provider Name | Christa Dawn Randolph |
|---|---|
| Address | 306 W Main St, Bridgeport, |
| Phone Number | 3048423137 |
| Fax Number | 3048423138 |
| Sole Proprietor | N |
| Credentials | MPT |
NPI Number Detail
| NPI Number | 1174508121 |
|---|---|
| Provider Enumeration Date | 2005-12-13 |
| Last Updated Date | 2012-07-12 |
Provider Mailing Address Detail
| Address | 306 W Main St |
|---|---|
| City | Bridgeport |
| State | (WV) |
| Post Code | 263301751 |
| Phone Number | 3048423137 |
| Fax Number | 3048423138 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 2526 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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What is the unique 10-digit identification code assigned to Christa Dawn Randolph by the Centers for Medicare & Medicaid Services?
The Christa Dawn Randolph has been issued the NPI (National Provider Identifier) 1174508121, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Christa Dawn Randolph?
The Christa Dawn Randolph is physically situated at 306 W Main St, in the city of Bridgeport, state of WV, with the postal code 263301751.
What is the Christa Dawn Randolph's area of specialization and corresponding taxonomy classification?
The Christa Dawn Randolph's specialty field is Specialist, and it falls under the taxonomy code 174400000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1174508121 to Christa Dawn Randolph?
The Christa Dawn Randolph received its 1174508121 assignment from the Centers for Medicare & Medicaid Services on 2005-12-13.
As of what date was the information regarding Christa Dawn Randolph, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Christa Dawn Randolph, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2012-07-12.