Healthcare Provider Details

I. General information

NPI: 1487637435
Provider Name (Legal Business Name): ALLEN M LAWS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 HOSPITAL DR SUITE 5
GALAX VA
24333-2454
US

IV. Provider business mailing address

205 MOUNTAIN RIDGE LN
GALAX VA
24333-1839
US

V. Phone/Fax

Practice location:
  • Phone: 276-236-6136
  • Fax: 276-236-2536
Mailing address:
  • Phone: 540-236-7673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101-040945
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: