Provider Demographics
NPI:1548242449
Name:ALLEN, CHRISTOPHER C (MD)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:C
Last Name:ALLEN
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 1:50 BERRY ROAD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301
Mailing Address - Country:US
Mailing Address - Phone:724-222-1125
Mailing Address - Fax:724-222-1373
Practice Address - Street 1:50 BERRY ROAD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301
Practice Address - Country:US
Practice Address - Phone:724-222-1125
Practice Address - Fax:724-222-1373
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD057241L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1543378Medicaid
E71870Medicare UPIN
PA1543378Medicaid