Provider Demographics
NPI:1255402558
Name:ALLEN, BETTE C (MD)
Entity type:Individual
Prefix:DR
First Name:BETTE
Middle Name:C
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9608 PERALTA RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-6360
Mailing Address - Country:US
Mailing Address - Phone:505-797-0286
Mailing Address - Fax:
Practice Address - Street 1:5901 HARPER DRIVE NE
Practice Address - Street 2:PRESBYTERIAN WOUND CENTER
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3587
Practice Address - Country:US
Practice Address - Phone:505-823-8870
Practice Address - Fax:505-823-8875
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM97-179207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NME88042Medicare UPIN