Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 57954 | MN |
N | 207X00000X | Orthopaedic Surgeon | 83373 | GA |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 83373 | GA |
NPI | 1578909396 |
---|---|
Provider Name | Melissa M Allen |
First Address | Augusta, GA 30912-0004 |
Second Address | Augusta, GA 30912-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2013 |
Last Update Date | 28/06/2019 |