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Individual

MICHAEL ROSS ALLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
4850 N 9TH AVE, PENSACOLA, FL 32503-2407
(850) 477-9015
(850) 478-5227
Mailing address
4850 N 9TH AVE, PENSACOLA, FL 32503-2407
(850) 477-9015
(850) 478-5227

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0775T
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1449868
IA
01
54775
WELLMARK
IA
Enumeration date
10/19/2005
Last updated
06/10/2019
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