Warren, Randy Lee

Warren, Randy Lee is an individual health care provider with primary practice located at 1101 Johnson Ave Suite 204, Myrtle Beach SC 29577-1893. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Warren, Randy Lee can be contacted via phone (843) 477-0177.

Contact Information

Primary practice address
1101 Johnson Ave Suite 204 Myrtle Beach SC 29577-1893
Phone: (843) 477-0177
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 21827 West Virginia

Profile Details

NPI number 1972614774
LBN Legal business name Warren, Randy Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Sep 30th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972614774 NPPES
West Virginia MEDICAID 381002129
West Virginia Other 002006862

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