Provider Demographics
NPI:1073560017
Name:DEEHRING, RANDALL CRAIG (MD)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:CRAIG
Last Name:DEEHRING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33709
Mailing Address - Street 2:VINEYARD PARK
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-3245
Mailing Address - Country:US
Mailing Address - Phone:440-937-3224
Mailing Address - Fax:
Practice Address - Street 1:29000 CENTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5293
Practice Address - Country:US
Practice Address - Phone:440-835-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35038444D207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine