Individual
WILLIAM BAKER ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2435 FOREST DR, COLUMBIA, SC 29204-2026
(803) 254-5140
(803) 779-1279
Mailing address
2435 FOREST DR, COLUMBIA, SC 29204-2026
(803) 254-5140
(803) 779-1279
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9918
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099182
—
SC
01
—
330002031
RAILROAD MEDICARE
SC
Enumeration date
01/25/2006
Last updated
12/30/2011
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