Provider Demographics
NPI:1326133299
Name:ALLEN, WARREN THOMAS (HS)
Entity Type:Individual
Prefix:MR
First Name:WARREN
Middle Name:THOMAS
Last Name:ALLEN
Suffix:
Gender:M
Credentials:HS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 EDITH LN
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-6401
Mailing Address - Country:US
Mailing Address - Phone:252-338-6119
Mailing Address - Fax:252-335-6255
Practice Address - Street 1:COMDT CG-1122 U S COAST GUARD
Practice Address - Street 2:2100 2ND ST SW, SUITE 5314
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593-0001
Practice Address - Country:US
Practice Address - Phone:252-335-6460
Practice Address - Fax:252-335-6255
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other