Provider Demographics
NPI:1033100581
Name:ALLEN, NORMAN W (MD)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:W
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 4427
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20791-4427
Mailing Address - Country:US
Mailing Address - Phone:202-399-5707
Mailing Address - Fax:202-399-5708
Practice Address - Street 1:1647 BENNING RD NE
Practice Address - Street 2:STE 201
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4569
Practice Address - Country:US
Practice Address - Phone:202-399-5707
Practice Address - Fax:202-399-5708
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD 21102207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC025501400Medicaid
G00335Medicare ID - Type Unspecified