Individual
DR. BRIAN MICHAEL ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
399 FARMINGTON AVE, SUITE 200, FARMINGTON, CT 06032-1936
(860) 548-7338
(860) 674-4232
Mailing address
399 FARMINGTON AVE, SUITE 200, FARMINGTON, CT 06032-1936
(860) 548-7338
(860) 674-4232
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
65381
GA
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
052813
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881892529
ANTHEM BCBS
CT
01
—
202I022436
MEDICARE PTAN
GA
Enumeration date
07/04/2007
Last updated
06/10/2014
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