Provider Demographics
NPI:1346294568
Name:DAVID W ALLEN M D P C
Entity Type:Organization
Organization Name:DAVID W ALLEN M D P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP,CNRN
Authorized Official - Phone:610-372-3002
Mailing Address - Street 1:4 PARK PLZ
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1398
Mailing Address - Country:US
Mailing Address - Phone:610-372-3002
Mailing Address - Fax:610-372-3007
Practice Address - Street 1:4 PARK PLZ
Practice Address - Street 2:SUITE 102
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1398
Practice Address - Country:US
Practice Address - Phone:610-372-3002
Practice Address - Fax:610-372-3007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1109060Medicaid
PA055778Medicare PIN
PAE21921Medicare UPIN