Provider Demographics
NPI:1275556508
Name:ADOLPHE, ALLEN B (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:B
Last Name:ADOLPHE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:MSC 10 550
Mailing Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-5271
Mailing Address - Country:US
Mailing Address - Phone:505-272-2700
Mailing Address - Fax:505-272-0074
Practice Address - Street 1:MSC 10 550
Practice Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-2700
Practice Address - Fax:505-272-0074
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-10-20
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Provider Licenses
StateLicense IDTaxonomies
NM811207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM22103Medicaid
C78428Medicare UPIN