| Doctor Name: | MS. CYNTHIA RANDOLPH |
| NPI Number: | 1326113242 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.A.C. |
| License Number: | C0002701 |
| Business Practice Address: | 12547 Ocean Gateway Ocean City, MD - 218429341 |
| Business Phone Number: | 4102130119 |
| Business Fax Number: | 4102132875 |
| Mailing Address: | 12547 Ocean Gateway, OCEAN CITY |
| State: | MD |
| Postal Code: | 218429341 |
| Phone Number: | 4102130119 |
| Fax Number: | 4102132875 |
| NPI Enumeration Date: | 11/24/2006 |
| NPI Last Update Date: | 01/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | C0002701 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |