Provider Demographics
NPI:1104813443
Name:ENGEL, ALLAN NORMAN (MD)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:NORMAN
Last Name:ENGEL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2000 WASHINGTON ST
Mailing Address - Street 2:SUITE 568
Mailing Address - City:NEWTON LOWER FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1650
Mailing Address - Country:US
Mailing Address - Phone:677-244-7142
Mailing Address - Fax:617-630-0720
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:SUITE 568
Practice Address - City:NEWTON LOWER FALLS
Practice Address - State:MA
Practice Address - Zip Code:02462-1650
Practice Address - Country:US
Practice Address - Phone:677-244-7142
Practice Address - Fax:617-630-0720
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2011-09-14
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Provider Licenses
StateLicense IDTaxonomies
MA42921207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2092689Medicaid
MA2092689Medicaid