MEDICARE: JOHN J. ALLAN 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	207RC0000X	Cardiovascular Disease Physician	9701683	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

General Provider Information

NPI Number	:	1235121997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN J. ALLAN M.D.

Provider Business Mailing Address
First Line	:	1424 FERN CREEK DR
Second Line	:	SUITE D
City	:	STATESVILLE
State	:	NC
Zip	:	28625-9376
Country	:	US
Telephone Number	:	704-878-2058
Fax Number	:	704-872-6576

Provider Business Practice Location Address
First Line	:	1424 FERN CREEK DR
Second Line	:	SUITE D
City	:	STATESVILLE
State	:	NC
Zip	:	28625-9376
Country	:	US
Telephone Number	:	704-878-2058
Fax Number	:	704-872-6576

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	04/16/2021

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