Individual
DR. CLINT TANNER ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6420 ROCKLEDGE DR, SUITE 4920, BETHESDA, MD 20817-7837
(301) 896-3331
Mailing address
6420 ROCKLEDGE DR, SUITE 4920, BETHESDA, MD 20817-7837
(301) 896-3331
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
0101275391
VA
207Y00000X
Otolaryngology Physician
Primary
D76403
MD
207Y00000X
Otolaryngology Physician
MD60276311
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0294408
L&I
WA
05
—
1861697021
—
WA
Enumeration date
06/18/2007
Last updated
11/15/2022
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