Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 017383 | GA |
N | 207ND0900X | Dermatopathologist | 017383 | GA |
N | 207NP0225X | Pediatric Dermatologist | 017383 | GA |
N | 207NS0135X | Procedural Dermatology | 017383 | GA |
N | 208D00000X | General Practice Physician | 017383 | GA |
NPI | 1518968338 |
---|---|
Provider Name | Dr. Allen B Filstein |
First Address | Dublin, GA 31021-2885 |
Second Address | Conyers, GA 30012-3871 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 22/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0300073 | EVERCARE (01) | |
031625 | UNITED HEALTHCARE (01) | |
0565235 | AETNA (01) | |
070010646 | RAILROAD MEDICARE (01) | |
144127 | BCBS (01) | |
2788 | KAISER (01) | |
9912601 | CIGNA (01) | |
D29470 | (02) | GA |