Randall, Wendell Lewis

Randall, Wendell Lewis is an individual health care provider with primary practice located at 956 N Main St , Mount Airy NC 27030-3747. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Randall, Wendell Lewis can be contacted via phone (336) 648-8550.

Contact Information

Primary practice address
956 N Main St Mount Airy NC 27030-3747
Phone: (336) 648-8550
Fax: (336) 648-8551
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 36016 North Carolina
Allopathic & Osteopathic Physicians / General Practice 208D00000X 36016 North Carolina

Profile Details

NPI number 1902856065
LBN Legal business name Randall, Wendell Lewis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2006
Last updated May 17th, 2023 - about 2 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 1902856065 NPPES
Virginia Other VVF492B944 MEDICARE NUMBER
Virginia Other 70121 MEDICARE NUMBER
Virginia MEDICAID 89070121 MEDICARE NUMBER
Virginia Other 36016 MEDICARE NUMBER

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