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Individual
TYLER D ALLEN
Active
Individual
TYLER D ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-01272
NC
363AM0700X
Medical Physician Assistant
0010-01272
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053583294
—
NC
01
—
1596T
BCBSNC
NC
Enumeration date
03/27/2008
Last updated
12/07/2016
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