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Individual

DR. CHARLES D ALLEN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
49 GOVERNORS AVE, MEDFORD, MA 02155-3017
(781) 395-6122
(781) 395-2595
Mailing address
49 GOVERNORS AVE, MEDFORD, MA 02155-3017
(781) 395-6122
(781) 395-2595

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
40486
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
040486
TUFTS
MA
05
2058502
MA
01
8475
HARVARD PIL
MA
01
B53097
BCBS
MA
Enumeration date
12/08/2005
Last updated
07/08/2007
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