Provider Demographics
NPI:1275669368
Name:SATHER, RANDALL KENNETH (MD)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:KENNETH
Last Name:SATHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:206 N BOUNDARY ST
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-3701
Mailing Address - Country:US
Mailing Address - Phone:919-932-3744
Mailing Address - Fax:919-932-4453
Practice Address - Street 1:100 EUROPA DR
Practice Address - Street 2:SUITE 417
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-2357
Practice Address - Country:US
Practice Address - Phone:919-932-3744
Practice Address - Fax:919-932-4453
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC189042085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC81064Medicare UPIN