MEDICARE: SURYADEV R ALLAM MD

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	207R00000X	Internal Medicine Physician	347900	LA

General Provider Information

NPI Number	:	1760125231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SURYADEV R ALLAM MD

Provider Business Mailing Address
First Line	:	610 SENTRY PKWY STE 102
Second Line	:
City	:	BLUE BELL
State	:	PA
Zip	:	19422-2314
Country	:	US
Telephone Number	:	484-965-9566
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 4TH ST
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-8421
Country	:	US
Telephone Number	:	318-769-3000
Fax Number	:

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

Provider Enumeration Date	:	04/13/2022
Last Update Date	:	12/16/2025

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