Provider Demographics
NPI:1700895562
Name:CUTHBERTSON, RAND J (MD)
Entity Type:Individual
Prefix:DR
First Name:RAND
Middle Name:J
Last Name:CUTHBERTSON
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:PO BOX 1428
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45802-1428
Mailing Address - Country:US
Mailing Address - Phone:844-466-5613
Mailing Address - Fax:419-223-2726
Practice Address - Street 1:42 SAVAGE ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-2410
Practice Address - Country:US
Practice Address - Phone:330-474-3112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG1710152085R0202X
OH35.1341662085R0202X
SC216872085R0202X, 2085R0202X
NMMD2021-08572085R0202X
SCME216872085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC216877Medicaid
PA001276200-0006Medicaid
SC3051A948OtherMEDICARE GROUP
OH0301423Medicaid
CA1700895562Medicaid
NM77082524Medicaid