Randolph, Erich Graham

Randolph, Erich Graham is an individual health care provider with primary practice located at 320 Parkway Dr Ne 300, Atlanta GA 30312-1213. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Radiation Oncology. Allopathic & Osteopathic Physicians / Radiation Oncology is his primary health care specialty. Randolph, Erich Graham can be contacted via phone (404) 522-6569.

Contact Information

Primary practice address
320 Parkway Dr Ne 300 Atlanta GA 30312-1213
Phone: (404) 522-6569
Fax: (404) 522-8265
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 021790 Georgia
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 021790 Georgia

Profile Details

NPI number 1598703456
LBN Legal business name Randolph, Erich Graham
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2006
Last updated May 17th, 2019 - about 5 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 1598703456 NPPES
Georgia MEDICAID 000305951R
Georgia Other 92BBGBZ
Georgia MEDICAID 000305951S
Georgia MEDICAID 000305951L
Georgia MEDICAID 000305951O
Georgia MEDICAID 000305951T
Georgia MEDICAID 000305951Q
Georgia MEDICAID 000305951M
Georgia MEDICAID 000305951P
Georgia MEDICAID 000305951N

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