Provider Demographics
NPI:1366728610
Name:CULPEPPER, RANDALL (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:
Last Name:CULPEPPER
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2034 EISENHOWER AVE
Mailing Address - Street 2:SUITE 270
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-5326
Mailing Address - Country:US
Mailing Address - Phone:301-910-9203
Mailing Address - Fax:
Practice Address - Street 1:2034 EISENHOWER AVE
Practice Address - Street 2:SUITE 270
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-5326
Practice Address - Country:US
Practice Address - Phone:301-910-9203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360815432083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine