Provider Demographics
NPI:1740496306
Name:ALLEN, DAVID WEBSTER (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:WEBSTER
Last Name:ALLEN
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:VA WEST ROXBURY
Mailing Address - Street 2:1400 VFW PKWY DEPARTMENT OF RADIOLOGY
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132
Mailing Address - Country:US
Mailing Address - Phone:857-203-5745
Mailing Address - Fax:914-493-7561
Practice Address - Street 1:VA WEST ROXBURY
Practice Address - Street 2:1400 VFW PKWY DEPARTMENT OF RADIOLOGY
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132
Practice Address - Country:US
Practice Address - Phone:857-203-5745
Practice Address - Fax:914-493-7561
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2488642085R0204X
MA2466442085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology