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Individual

CHRISTIAN FREDERICK ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 794-0477
(770) 794-3108
Mailing address
PO BOX 1950, DOUGLASVILLE, GA 30133-1950
(706) 660-8505
(706) 660-9390

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002844
GA
367H00000X
Anesthesiologist Assistant
Primary
2844
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
491431789A
GA
05
640402698A
GA
Enumeration date
11/19/2005
Last updated
06/17/2020
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