Rodrigue, Randolph L

Rodrigue, Randolph L is an individual health care provider with primary practice located at 170 Amendment Ave , Rock Hill SC 29732. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Rodrigue, Randolph L can be contacted via phone (803) 324-7607.

Contact Information

Primary practice address
170 Amendment Ave Rock Hill SC 29732
Fax: (803) 324-1449
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 15777 South Carolina

Profile Details

NPI number 1104880095
LBN Legal business name Rodrigue, Randolph L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2006
Last updated Jun 10th, 2011 - about 14 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 1104880095 NPPES
South Carolina MEDICAID PL0664
South Carolina MEDICAID TL5901

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