DR. CHARLES D ALLEN (NPI# 1720063142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720063142 |
| Entity Type | Individual |
| Full Name | DR. CHARLES D ALLEN |
| Credential | MD |
| Practice Address |
49 Governors Ave Medford MA 02155-3017 |
| Practice Telephone | 7813956122 |
| Practice Fax Number | 7813952595 |
| Mailing Telephone | 7813956122 |
| Mailing Fax Number | 7813952595 |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 40486 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | HARVARD PIL | 8475 | 01 |
| MA | TUFTS | 040486 | 01 |
| MA | 2058502 | 05 | |
| MA | BCBS | B53097 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912444647 | Charles Tyler Allen | Chiropractor | 818 Knights Cross Dr, Ste. 5107, San Antonio, TX 78258-2982 | 2017-01-19 |
| 1023495355 | Charles Allen Jr. | Licensed Practical Nurse | 4421 Granada Blvd, Apt 533, Warrensville Heights, OH 44128-4823 | 2015-05-06 |
| 1861804668 | Charles Allen | Counselor | 1717 Seascape Cir, Tarpon Springs, FL 34689-2962 | 2014-05-28 |
| 1205248143 | Charles William Allen II | Marriage & Family Therapist | 11500 Olympic Ave, # 420, Los Angeles, CA 90064 | 2014-05-27 |
| 1922344522 | Charles William Allen Sr. | Nutritionist | 9703 Ne 2nd Pl, Oklahoma City, OK 73130-3509 | 2012-12-31 |
| 1215133319 | Charles Allen | Emergency Medicine | 1275 So State St, Dover, DE 19901 | 2007-06-25 |
| 1144345364 | Charles T Allen | Podiatrist | 5700 S Kedzie Ave, Chicago, IL 60629-2408 | 2007-03-20 |
| 1144370958 | Charles Davis Allen Jr. | Dentist | 508 Mckay St., Elizabethtown, NC 28337-0235 | 2007-01-12 |
| 1124053251 | Charles Allen | Pharmacist | 221 Flagstone Ln, Raeford, NC 28376-3260 | 2006-07-11 |
| 1548216237 | Charles J Allen | Occupational Therapist | 2108 Joshuas Path, Hauppauge, NY 11788-4764 | 2006-05-25 |
| Street Address |
49 GOVERNORS AVE |
| City | MEDFORD |
| State | MA |
| Zip Code | 02155-3017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588929947 | Samantha Morrison-ma | Nurse Practitioner | 49 Governors Ave, Hallmark Health Medical Associates Inc., Medford, MA 02155-3017 | 2012-07-11 |
| 1730130832 | Catherine S Tucker | Surgery | 49 Governors Ave, Hallmark Health Medical Associates Inc, Medford, MA 02155-3017 | 2006-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679113922 | Elena Chapman | Nurse Practitioner | 293 Salem St 4, Medford, MA 02155 | 2020-01-14 |
| 1922658830 | Michelle Anne Zona | Counselor | 100 George Hassett Dr, Medford, MA 02155 | 2019-09-13 |
| 1487138509 | Dava Davainis | Social Worker | 76 Newbern Avenue, Apt. 1, Medford, MA 02155 | 2018-09-25 |
| 1265915128 | Erin Roberts | Counselor | Medford Public Schools, 3002 Mystic Valley Pkwy, Medford, MA 02155 | 2018-09-07 |
| 1871075739 | Janice Madeline Cole | Social Worker | 3820 Mystic Valley Pkwy Unit 805, Medford, MA 02155 | 2018-09-06 |
| 1447732573 | Mystick Women's Health, Inc. | Obstetrics & Gynecology | 13 Bradlee Road, Medford, MA 02155 | 2018-09-05 |
| 1144713090 | Laura Rogers | Psychologist | 203 Paige Hall, 12 Upper Campus Road, Medford, MA 02155 | 2018-06-14 |
| 1871086694 | Shuo Yang | Dentist | 8 9th St Apt 310, Medford, MA 02155 | 2018-06-07 |
| 1891287108 | Xuhua Qin | Psychologist | 120 Curtis Street, Medford, MA 02155 | 2018-06-01 |
| 1568953529 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 471 Salem St, Medford, MA 02155 | 2018-05-25 |
| Find all providers in zip 02155 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871740787 | Milton W Kim | Surgery | 746 Marshall Ave, Medford, OR 97501-4017 | 2008-08-21 |
| 1811078132 | John Clifton Brawner | Surgery | 1297 Gardner Way, Medford, OR 97504-9300 | 2006-10-17 |
| 1831100262 | Erik T Branstetter | Surgery | 143 S Gibson St, Medford, WI 54451-1622 | 2006-08-10 |
| 1477593713 | Juan C Vasquez | Surgery | 1698 E Mcandrews Rd Ste 160, Medford, OR 97504-5590 | 2006-06-07 |
| 1568789527 | Hallmark Health Medical Associates Inc | Surgery | 170 Governors Ave, Attn: Provider Enrollment-hhma (3) Contact, Medford, MA 02155-1643 | 2010-04-29 |
| 1861677460 | Ronald G Worland | Surgery | 2959 Siskiyou Blvd, Ste A, Medford, OR 97504-8131 | 2008-01-02 |
| 1316131279 | Wie-peng Kuo | Surgery | 1698 E Mcandrews Rd, Suite 160, Medford, OR 97504-5589 | 2007-09-04 |
| 1144412529 | Patrick Joseph Phelan | Surgery | 520 Medical Center Dr, Ste 300, Medford, OR 97504-4316 | 2007-08-09 |
| 1457555237 | Mitchell Martin Plummer | Surgery | 520 Medical Center Dr, Ste 300, Medford, OR 97504-4316 | 2007-06-13 |
| 1356422596 | David Karl Traul | Surgery | 520 Medical Center Dr, Ste 300, Medford, OR 97504-4316 | 2006-10-17 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.