Provider Demographics
NPI:1568434801
Name:SCHACTER, RANDIE (DO)
Entity Type:Individual
Prefix:
First Name:RANDIE
Middle Name:
Last Name:SCHACTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:RANDIE
Other - Middle Name:
Other - Last Name:FITZGERALD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:212 W MATTHEWS ST STE 106
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5442
Mailing Address - Country:US
Mailing Address - Phone:704-847-0424
Mailing Address - Fax:704-847-0454
Practice Address - Street 1:212 W MATTHEWS ST STE 106
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5442
Practice Address - Country:US
Practice Address - Phone:704-847-0424
Practice Address - Fax:704-847-0454
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005015832084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCN01580Medicaid
NC5902850Medicaid
SCN01580Medicaid
NC5902850Medicaid