Provider Demographics
NPI:1942568936
Name:ALLEN, MICHAEL BRANDON (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:BRANDON
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2004 HAYES ST # LL30
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2646
Mailing Address - Country:US
Mailing Address - Phone:615-284-7950
Mailing Address - Fax:156-284-5750
Practice Address - Street 1:2000 CHURCH ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37236-5423
Practice Address - Country:US
Practice Address - Phone:615-284-7950
Practice Address - Fax:615-284-5750
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE-10396207ZP0102X, 207ZP0102X
TN72124207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Yes207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology