Provider Demographics
NPI:1972501856
Name:BAR, ALLEN H (MD)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:H
Last Name:BAR
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 1:301 S 8TH ST
Mailing Address - Street 2:SUITE 4A
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-4000
Mailing Address - Country:US
Mailing Address - Phone:215-829-8455
Mailing Address - Fax:215-829-8454
Practice Address - Street 1:301 S 8TH ST
Practice Address - Street 2:SUITE 4A
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-4000
Practice Address - Country:US
Practice Address - Phone:215-829-8455
Practice Address - Fax:215-829-8454
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD010352E174400000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000778010-00003Medicaid
PA154463Medicare PIN
PAC32118Medicare UPIN