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General NPI Number Information
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NPI Number | 1083982011
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Entity Type | Organization
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Legal Business Name | BRUCE H ALLEN MD INC
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Dates
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Enumeration Date | 12/05/2011
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Last Update Date | 12/05/2011
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Provider Practice Location Address
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Address Line | 2752 ERIE AVE
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City | CINCINNATI
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State | OH
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Zip | 45208-2207
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Country | US
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Telephone | 513-871-0290
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Fax | 513-871-6740
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Provider Business Mailing Address
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Address Line | 2752 ERIE AVE
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City | CINCINNATI
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State | OH
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Zip | 45208-2207
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Country | US
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Telephone | 513-871-0290
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Fax | 513-871-6740
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRUCE HOWARD ALLEN
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Credential | MD
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Telephone | 513-310-1104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 39480
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License Number State | OH
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