Provider Demographics
NPI:1093772808
Name:AVBEL, ALLAN F (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:F
Last Name:AVBEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 CRAIG ST
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-3302
Mailing Address - Country:US
Mailing Address - Phone:509-522-1951
Mailing Address - Fax:509-522-1951
Practice Address - Street 1:306 CRAIG ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-3302
Practice Address - Country:US
Practice Address - Phone:509-522-1951
Practice Address - Fax:509-522-1951
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA167802085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ102585Medicaid
AZ102585Medicaid
F56888Medicare UPIN
AZP00309657Medicare PIN