Provider Demographics
NPI:1477526283
Name:ALLMAN, LARA M (DPM)
Entity type:Individual
Prefix:DR
First Name:LARA
Middle Name:M
Last Name:ALLMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 BEAVER DR
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-2517
Mailing Address - Country:US
Mailing Address - Phone:814-371-0300
Mailing Address - Fax:
Practice Address - Street 1:207 BEAVER DR
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2517
Practice Address - Country:US
Practice Address - Phone:814-371-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004334L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001711419002Medicaid
PA008549Medicare ID - Type Unspecified
PAU70639Medicare UPIN