Mitchell Hurst Allen, MD
Individual provider Active NPI Gastroenterology Physician · Spartanburg, SC
NPI 1861463671 · NPPES record last updated Dec 13, 2007
Key facts
- NPI
- 1861463671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- License
- 7751 (SC)
- Practice address
- 853 N Church St
Suite 620
Spartanburg, SC 29303-3098 - Phone
- (864) 573-7511
- Fax
- (864) 560-1690
- NPI assigned
- Jan 30, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7751 | SC | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 7751 | SC | Yes |
Addresses
Primary practice location
853 N Church St
Suite 620
Spartanburg, SC 29303-3098
Mailing address
PO Box 2168
Spartanburg, SC 29304-2168
Phone (864) 560-4304
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7905049 | Medicaid | NC | |
| 20219 | Other | SC | MEDCOST |
| 077516 | Medicaid | SC | |
| 4226826 | Other | SC | AETNA |
Other providers in Spartanburg, SC
- Cricket Hull Allen
- Heather Newlin Allen
- Jennifer F Allen
- Julia Snead Allen
- Kala Allen
- Rebecca Jane Allen
- Allergic Disease and Asthma Center
- Allergy Partners, PLLC
- Rebecca S Allison
- Thomas Frederick Allred
All providers in Spartanburg, SC · Gastroenterology Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.