Healthcare Provider Details

I. General information

NPI: 1124035571
Provider Name (Legal Business Name): MICHAEL CHRISTIAN ALLAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 09/01/2020
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 MCCALLIE AVE
CHATTANOOGA TN
37404-3230
US

IV. Provider business mailing address

2205 MCCALLIE AVE
CHATTANOOGA TN
37404-3230
US

V. Phone/Fax

Practice location:
  • Phone: 423-508-6733
  • Fax: 423-508-6744
Mailing address:
  • Phone: 423-508-6733
  • Fax: 423-508-6744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number37023
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number37023
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: