Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 035802 | GA |
NPI | 1144230251 |
---|---|
Provider Name | Dr. Raymond J. Allen |
First Address | Atlanta, GA 30342-1606 |
Second Address | Atlanta, GA 30342-1606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 23/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000512707C | (05) | GA |
000512707F | (05) | GA |
000512707H | (05) | GA |
000512707I | (05) | GA |
000512707M | (05) | GA |
00512707E | (05) | GA |
A52689 | (02) | GA |