Provider Demographics
NPI:1760474423
Name:ALLEN, JAMES B III (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:B
Last Name:ALLEN
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:157 PROFESSIONAL PARK DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-5605
Mailing Address - Country:US
Mailing Address - Phone:704-662-3967
Mailing Address - Fax:704-662-3975
Practice Address - Street 1:157 PROFESSIONAL PARK DR
Practice Address - Street 2:SUITE A
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-5605
Practice Address - Country:US
Practice Address - Phone:704-662-3967
Practice Address - Fax:704-662-3975
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2020-09-08
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Provider Licenses
StateLicense IDTaxonomies
NC200100116207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8912990Medicaid
NCH47892Medicare UPIN