Provider Demographics
NPI:1053449652
Name:ALLEN, THOMAS E (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7600 OSLER DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7735
Mailing Address - Country:US
Mailing Address - Phone:410-821-8351
Mailing Address - Fax:
Practice Address - Street 1:7600 OSLER DR
Practice Address - Street 2:SUITE 201
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7735
Practice Address - Country:US
Practice Address - Phone:410-821-8351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00029102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
754RMedicare PIN