Individual
DR. MARTY ALLEN
Active
Individual
DR. MARTY ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
39516
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000703653
ANTHEM- NIS
KY
01
—
000057119E
HUMANA- NIS
KY
05
—
200868800
—
IN
01
—
50031894
PASSPORT- NIS
KY
05
—
7100008660
—
KY
01
—
P00912388
RAILROAD MEDICARE- NIS
KY
Enumeration date
02/02/2007
Last updated
03/14/2013
Update your record
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