Healthcare Provider Details

I. General information

NPI: 1518909613
Provider Name (Legal Business Name): MARIAN C ALLEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 HOSPITAL DR STE 102
CLYDE NC
28721-0107
US

IV. Provider business mailing address

3430 BAXTER VIEW DR
MARYVILLE TN
37804-2417
US

V. Phone/Fax

Practice location:
  • Phone: 828-456-9006
  • Fax: 828-456-8199
Mailing address:
  • Phone: 832-549-5704
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2025-03670
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: