MEDICARE: DR. ROBERT SCOTT ALLEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant		NC

General Provider Information

NPI Number	:	1154309359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT SCOTT ALLEN MD

Provider Business Mailing Address
First Line	:	2085 FRONTIS PLAZA BLVD
Second Line	:	3RD FLOOR (ATTN: FORSYTH MEDICAL GROUP)
City	:	WINSTON-SALEM
State	:	NC
Zip	:	27103-5614
Country	:	US
Telephone Number	:	336-277-1473
Fax Number	:	336-277-9275

Provider Business Practice Location Address
First Line	:	186 KIMEL PARK DR
Second Line	:	ATTN: WINSTON-SALEM CARDIOLOGY ASSOCIATES
City	:	WINSTON-SALEM
State	:	NC
Zip	:	27103-6946
Country	:	US
Telephone Number	:	336-277-2000
Fax Number	:	336-277-2050

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	07/08/2007

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