Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0100X | Gastroenterologist | 30535 | NC |
NPI | 1033188487 |
---|---|
Provider Name | Dr. Herbert Richard Allen |
First Address | Raleigh, NC 27619-8563 |
Second Address | South Hill, VA 23970-1421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 22/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
005828449 | (05) | VA |
B07261 | (02) | VA |