Organization
MARK L ALLEN MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK L ALLEN MD (OWNER)
(216) 674-5230
Entity
Organization
Contact information
Practice address
6701 ROCKSIDE RD, SUITE 200, INDEPENDENCE, OH 44131-2358
(216) 674-5230
(216) 674-5231
Mailing address
6701 ROCKSIDE RD, SUITE 200, INDEPENDENCE, OH 44131-2358
(216) 674-5230
(216) 674-5231
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
18589
KS
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0058842
—
OH
01
—
H082431
MEDICARE PTAN
OH
Enumeration date
03/27/2012
Last updated
11/30/2012
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