Provider Demographics
NPI:1548253834
Name:ALLEN, MARK D (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:D
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:318 N LANSDOWNE AVE
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-1018
Mailing Address - Country:US
Mailing Address - Phone:610-259-8344
Mailing Address - Fax:610-259-3385
Practice Address - Street 1:318 N LANSDOWNE AVE
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050-1018
Practice Address - Country:US
Practice Address - Phone:610-259-8344
Practice Address - Fax:610-259-3385
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-23
Last Update Date:2016-11-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD038491L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0103215202OtherAMERICHOICE
PA1148659OtherKEYSTONE MERCY
PA15010OtherBRAVO ELDER HEALTH
PA13361OtherHEALTH PARTNERS
PA995155OtherHIGHMARK
PA001032152Medicaid
PAP00197203OtherRR MEDICARE
PA1148659OtherKEYSTONE MERCY
PA15010OtherBRAVO ELDER HEALTH