Provider Demographics
NPI:1073540647
Name:ALLEN, ROBERT M (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 708
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-0708
Mailing Address - Country:US
Mailing Address - Phone:269-428-5007
Mailing Address - Fax:269-428-2789
Practice Address - Street 1:1234 NAPIER AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-2112
Practice Address - Country:US
Practice Address - Phone:269-471-7741
Practice Address - Fax:269-471-1581
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301056577207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
4876196OtherCIGNA
MI1101100942OtherBLUE CROSS PIN
MI1538397120OtherGROUP NPI
MI43882593-Medicaid
MI04-31477OtherPHP
MI270381199OtherGROUP TAX ID
110128164OtherRAILROAD MEDICARE
110128164OtherRAILROAD MEDICARE
110128164OtherRAILROAD MEDICARE
MI1538397120OtherGROUP NPI