Provider Demographics
NPI:1790767424
Name:OU, ALAN C (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:C
Last Name:OU
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12504 KNIGHTSBRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3731
Mailing Address - Country:US
Mailing Address - Phone:504-669-2030
Mailing Address - Fax:
Practice Address - Street 1:1401 ROCKVILLE PIKE, HFM-224
Practice Address - Street 2:FDA/CBER
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852
Practice Address - Country:US
Practice Address - Phone:301-827-4061
Practice Address - Fax:301-827-3529
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-17
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 10061207Q00000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIPENDINGMedicaid
HIPENDINGMedicaid
PENDINGMedicare ID - Type Unspecified