| Doctor Name: | DR. RANDOLPH ROBERT MACDONALD |
| NPI Number: | 1831299429 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ED.D. |
| License Number: | 135 |
| Business Practice Address: | 1003 Sallie Ln Shepherdstown, WV - 254434044 |
| Business Phone Number: | 3047259645 |
| Business Fax Number: | |
| Mailing Address: | Po Box 209, SHEPHERDSTOWN |
| State: | WV |
| Postal Code: | 254434044 |
| Phone Number: | 3047259645 |
| Fax Number: | |
| NPI Enumeration Date: | 09/23/2006 |
| NPI Last Update Date: | 03/13/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 135 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |