Provider Demographics
NPI:1124002860
Name:TESSER, ALLEN N (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:N
Last Name:TESSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3058 METROPOLITAN PKWY
Mailing Address - Street 2:STE 208
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310
Mailing Address - Country:US
Mailing Address - Phone:586-939-6400
Mailing Address - Fax:586-939-6401
Practice Address - Street 1:3058 METROPOLITAN PKWY
Practice Address - Street 2:STE 208
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310
Practice Address - Country:US
Practice Address - Phone:586-939-6400
Practice Address - Fax:586-939-6401
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301035199207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
05026075071Medicare ID - Type Unspecified
B43751Medicare UPIN