Provider Demographics
NPI:1497849087
Name:SAVELL, RANDALL L (MD)
Entity Type:Individual
Prefix:
First Name:RANDALL
Middle Name:L
Last Name:SAVELL
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 1:3520 AIRPORT BLVD NW STE F
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-8674
Mailing Address - Country:US
Mailing Address - Phone:252-206-5622
Mailing Address - Fax:252-206-5623
Practice Address - Street 1:3520 AIRPORT BLVD NW STE F
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896
Practice Address - Country:US
Practice Address - Phone:252-206-5622
Practice Address - Fax:252-206-5623
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34154207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8974623Medicaid
NC74623OtherBCBS NC
NC8974623Medicaid
NCNCA971C129Medicare PIN