Provider Demographics
NPI:1477511889
Name:ALLEGRA, LUDWIG A (MD)
Entity Type:Individual
Prefix:
First Name:LUDWIG
Middle Name:A
Last Name:ALLEGRA
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 1:3100 CARILLON POINT
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7306
Mailing Address - Country:US
Mailing Address - Phone:425-576-1700
Mailing Address - Fax:425-827-7725
Practice Address - Street 1:3100 CARILLON POINT
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7306
Practice Address - Country:US
Practice Address - Phone:425-576-1700
Practice Address - Fax:425-827-7725
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00018191207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA000100082Medicare PIN
040002487Medicare PIN
WAA03963Medicare UPIN