Smith, Randolph Edward
Smith, Randolph Edward is an individual health care provider with primary practice located at 420 W Magnetic St , Marquette MI 49855-2711. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Smith, Randolph Edward can be contacted via phone (906) 228-9440.Contact Information
Primary practice address
420 W Magnetic St
Marquette MI 49855-2711
Phone: (906) 228-9440
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 4301046452 | Michigan |
Profile Details
| NPI number | 1063589216 |
|---|---|
| LBN Legal business name | Smith, Randolph Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 30th, 2006 |
| Last updated | Sep 4th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063589216 | NPPES |
| Michigan | Other | 2746496 | MOLINA HEALTHCARE |
| Michigan | MEDICAID | 34031400 | MOLINA HEALTHCARE |
| Michigan | MEDICAID | 2746796 | MOLINA HEALTHCARE |
| Michigan | Other | 1022271 | MOLINA HEALTHCARE |
| Michigan | Other | 2746796 | MOLINA HEALTHCARE |
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