Basic Information
| Provider Information | |||||||||
| NPI: | 1295340305 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALLEGRA | ||||||||
| FirstName: | PIERGIORGIO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 E BROADWAY # 50 | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652015844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5738158000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1601 E BROADWAY STE 260 | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652018041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5738155310 | ||||||||
| FaxNumber: | 5738155320 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2020 | ||||||||
| LastUpdateDate: | 08/09/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | 86849 | GA | Y | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.