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Individual

STEVEN ALLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1120 15TH ST, AUGUSTA, GA 30912-2849
(706) 721-8623
(706) 721-1459
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2019-01934
NC
207RP1001X
Pulmonary Disease Physician
Primary
96083
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1831553346
NC
01
NN8512A
MEDICARE
NC
Enumeration date
04/11/2016
Last updated
01/22/2024
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