MEDICARE: MATTHEW THOMAS ALLEMANG M.D.

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	208600000X	Surgery Physician	35.099627	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1174765531	OTHER	OH	NPI

General Provider Information

NPI Number	:	1174765531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW THOMAS ALLEMANG M.D.

Provider Business Mailing Address
First Line	:	20050 HARVARD AVE STE 107
Second Line	:
City	:	WARRENSVILLE HEIGHTS
State	:	OH
Zip	:	44122-6800
Country	:	US
Telephone Number	:	216-518-3650
Fax Number	:

Provider Business Practice Location Address
First Line	:	20050 HARVARD AVE STE 107
Second Line	:
City	:	WARRENSVILLE HEIGHTS
State	:	OH
Zip	:	44122-6800
Country	:	US
Telephone Number	:	216-518-3650
Fax Number	:

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

Provider Enumeration Date	:	04/01/2009
Last Update Date	:	02/19/2019

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