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NPI Code Detail

MEDICARE: DR. NATHAN D ALLISON M.D.

MEDICARE:  DR. NATHAN D ALLISON  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
1207RB0002XObesity Medicine (Internal Medicine) PhysicianME109885FL
2208600000XSurgery PhysicianME109885FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1FF615YOTHERFLMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003132887
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NATHAN D ALLISON M.D.
Provider Business Mailing Address
First Line : 3300 S FISKE BLVD
Second Line :
City : ROCKLEDGE
State : FL
Zip : 32955-4306
Country : US
Telephone Number : 321-434-9230
Fax Number : 321-951-7408
Provider Business Practice Location Address
First Line : 8725 N WICKHAM RD
Second Line : SUITE 302
City : MELBOURNE
State : FL
Zip : 32940-2239
Country : US
Telephone Number : 321-434-9230
Fax Number : 321-434-9231
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2010
Last Update Date : 11/10/2023

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