Individual
DR. RICHARD MICHAEL ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1630 23RD AVE, SUITE 1001, LEWISTON, ID 83501-6350
(208) 743-3688
(208) 743-5162
Mailing address
1630 23RD AVE, SUITE 1001, LEWISTON, ID 83501-6350
(208) 743-3688
(208) 743-5162
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
P-143
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010015686
REGENCE BLUESHIELD OF ID
ID
05
—
0027887
—
ID
01
—
P9186
BLUE CROSS OF IDAHO
ID
Enumeration date
08/11/2005
Last updated
11/07/2007
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