Individual
MS. ELAINE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
325 FOUR LEAF LN STE 11A, CHARLOTTESVILLE, VA 22903-9203
(434) 242-8550
(434) 205-4637
Mailing address
325 FOUR LEAF LN STE 11A, CHARLOTTESVILLE, VA 22903-9203
(434) 242-8550
(434) 205-4637
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
000744
GA
213ER0200X
Radiology Podiatrist
000744
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
000744
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000163909413
UNITED HEALTHCARE
—
05
—
00698167D
—
GA
01
—
323715
WELLCARE OF GEORGIA
GA
01
—
3641408
AETNA HMO
—
01
—
393136
BLUE CROSS BLUE SHEILD
GA
01
—
4572029
AETNA PPO/POS
—
01
—
5217840001
DMERC - PALMETTO
GA
01
—
P00240565
RAILROAD MEDICARE
—
Enumeration date
07/25/2006
Last updated
03/17/2018
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