Individual
MR. ANDREW DOUGLAS ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
11800 SUNRISE VALLEY DR STE 500, RESTON, VA 20191-5303
(703) 437-5977
(703) 478-2475
Mailing address
2901 TELESTAR CT., #300, FALLS CHURCH, VA 22042-1261
(703) 591-1688
(703) 591-1445
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003832
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01266198
RAILROAD MEDICARE
DC
Enumeration date
11/17/2008
Last updated
07/14/2023
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