Provider Demographics
NPI:1265562508
Name:ALLEN, CYRIL A (MD, MSPH)
Entity type:Individual
Prefix:DR
First Name:CYRIL
Middle Name:A
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD, MSPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3327 DUKE ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4597
Mailing Address - Country:US
Mailing Address - Phone:202-846-1412
Mailing Address - Fax:202-846-1418
Practice Address - Street 1:3327 DUKE ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4597
Practice Address - Country:US
Practice Address - Phone:202-846-1412
Practice Address - Fax:202-846-1418
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD33401207RH0003X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC035321900Medicaid
DCC80911Medicare UPIN