MEDICARE: MS. MARCHELLE ISYK ALLEN PA-C

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
1	363A00000X	Physician Assistant	0010-00586	NC

General Provider Information

NPI Number	:	1235230673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARCHELLE ISYK ALLEN PA-C

Provider Business Mailing Address
First Line	:	4601 PARK RD STE 300
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-2290
Country	:	US
Telephone Number	:	704-323-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	15235 JOHN J DELANEY DR STE B
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-2846
Country	:	US
Telephone Number	:	704-243-8937
Fax Number	:	704-243-8926

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	05/08/2024

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