Provider Demographics
NPI:1679669345
Name:SAOUD, ALLEN GEORGE (DO)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:GEORGE
Last Name:SAOUD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:170 THOMPSON DR STE 200
Mailing Address - Street 2:PO BOX 4550
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-2608
Mailing Address - Country:US
Mailing Address - Phone:304-842-2273
Mailing Address - Fax:304-842-2339
Practice Address - Street 1:170 THOMPSON DR STE 200
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-2608
Practice Address - Country:US
Practice Address - Phone:304-842-2273
Practice Address - Fax:304-842-2339
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV906207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C03762Medicare UPIN