NPI 1376165118 · live from the CMS NPI Registry
Khori-Jon Allen, PA-C
Physician Assistant in Waldorf, MD. National Provider Identifier 1376165118, active.
NPI record
| NPI | 1376165118 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 3510 Old Washington Rd Ste 100, Waldorf, MD 20602 |
| Practice phone | 301-932-5890 |
| Enumerated | May 14, 2020 |
| Last updated | November 23, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.