Blank, Randal Steven

Blank, Randal Steven is an individual health care provider with primary practice located at 1215 Lee St , Charlottesville VA 22908-0001. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Blank, Randal Steven can be contacted via phone (434) 984-2283.

Contact Information

Primary practice address
1215 Lee St Charlottesville VA 22908-0001
Phone: (434) 984-2283
Fax: (434) 982-0019
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 0101058927 Virginia
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 0101058927 Virginia

Profile Details

NPI number 1932147295
LBN Legal business name Blank, Randal Steven
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated Jul 23rd, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932147295 NPPES
Maryland Other 017182F85 MD MEDICARE GROUP G04185
Maryland Other 601285800 MD MEDICARE GROUP G04185
Maryland Other 839ML475 MD MEDICARE GROUP G04185
Maryland MEDICAID 407012700 MD MEDICARE GROUP G04185

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