MEDICARE: BRIAN D ALLEN MD PLLC

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	9600324	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	10678	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1225251796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIAN D ALLEN MD PLLC

Provider Business Mailing Address
First Line	:	923 NORTH SECOND ST
Second Line	:	SUITE 205
City	:	ALBEMARLE
State	:	NC
Zip	:	28001-3370
Country	:	US
Telephone Number	:	704-982-1399
Fax Number	:	704-982-1510

Provider Business Practice Location Address
First Line	:	923 NORTH SECOND STREET
Second Line	:	SUITE 205
City	:	ALBEMARLE
State	:	NC
Zip	:	28001-3370
Country	:	US
Telephone Number	:	704-982-1399
Fax Number	:	704-982-1510

Authorized Official
Title or Position	:	OWNER
Name	:	BRIAN D ALLEN
Credential	:	MD
Telephone Number	:	704-982-1399

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	08/22/2020

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