Willard, Randall Norman

Willard, Randall Norman is an individual health care provider with primary practice located at 4402 Shipyard Blvd , Wilmington NC 28403-6161. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Willard, Randall Norman can be contacted via phone (910) 452-1400.

Contact Information

Primary practice address
4402 Shipyard Blvd Wilmington NC 28403-6161
Phone: (910) 452-1400
Fax: (910) 332-1072
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 200400437 North Carolina

Profile Details

NPI number 1700880101
LBN Legal business name Willard, Randall Norman
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Nov 24th, 2009 - about 15 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 1700880101 NPPES
North Carolina MEDICAID 891368Y
North Carolina Other D7960
North Carolina Other P00311531
North Carolina MEDICAID Q0043G
North Carolina Other 1368Y

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