# DR. ALLEN A DZAMBO JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1174503791
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | SC004642L | PA | Yes |

## Other

- **Enumeration date:** 01/19/2006
- **Last updated:** 12/21/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0017663730003 | — | PA |
| 05 | — | 0017663730004 | — | PA |
| 01 | — | 001799222 | BLUE SHIELD | PA |