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Individual
ANDREA L ALLYN
Active
Individual
ANDREA L ALLYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30703
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000222285E
—
GA
05
—
1851363733
—
SC
01
—
AA2717
MEDICARE PTAN
SC
Enumeration date
02/03/2006
Last updated
07/23/2014
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