Provider Demographics
NPI:1598151672
Name:RANDALL, CARA (MD)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:RANDALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 MEDICAL CENTER DRIVE 2187, HSC-N, MS 9203
Mailing Address - Street 2:WVU UNIVERSITY DEPARTMENT OF PATHOLOGY AND LAB MEDICINE
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505
Mailing Address - Country:US
Mailing Address - Phone:304-293-7594
Mailing Address - Fax:
Practice Address - Street 1:64 MEDICAL CENTER DRIVE 2187, HSC-N, MS 9203
Practice Address - Street 2:WVU UNIVERSITY DEPARTMENT OF PATHOLOGY AND LAB MEDICINE
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505
Practice Address - Country:US
Practice Address - Phone:304-293-7594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-02491207ZP0102X
MDD0089734207ZP0102X
WV29769207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology