Provider Demographics
NPI:1598753451
Name:REDASH, ALLAN WAYNE (MD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:WAYNE
Last Name:REDASH
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 1:46 RED MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-9273
Mailing Address - Country:US
Mailing Address - Phone:828-484-8254
Mailing Address - Fax:
Practice Address - Street 1:46 RED MAPLE DR
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787-9273
Practice Address - Country:US
Practice Address - Phone:828-676-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-01194207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3327023Medicaid
TN3727982Medicaid
TNG12271Medicare UPIN
TN3327023Medicare ID - Type Unspecified
TN3727982Medicaid