Individual
MALCOLM S ALLEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
750 W 800 N, OREM, UT 84057-3660
(800) 748-4868
(801) 733-5618
Mailing address
46 N 960 E, AMERICAN FORK, UT 84003-2936
(801) 756-9919
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
213871-4406
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011517
HEALTHY U
UT
01
—
107007300107
IHC
UT
01
—
190382600
US DEPT OF LABOR
UT
01
—
75949
PEHP
UT
01
—
870525882AL2
EDUCATORS MUTUAL
UT
01
—
PRA07051
MOLINA
UT
01
—
QM0000076595
ALTIUS
UT
Enumeration date
09/12/2006
Last updated
07/08/2007
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