Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Randolph S Harrison, PA

Individual provider Physician Assistant · NPI 1104962620

Mr. Randolph S Harrison, PA is a Physician Assistant in Fort George G Meade, Maryland. Qualified in 2005, 21 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in Florida.

Years since qualifying
21
Licensed in
FL
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2480 Llewellyn Ave
Fort George G Meade, MD 20755-7081
Phone: (301) 677-8798
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 305 Maple Ave W, Vienna, VA 22180-4306 — (703) 992-7779

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1070437 (FL)

Record details

NPI number1104962620
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedJanuary 30, 2007
Last updated in NPPESApril 17, 2025
Certification dateApril 17, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Accepts Medicare assignment Not indicated

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