Healthcare Provider Details

I. General information

NPI: 1114188190
Provider Name (Legal Business Name): BRIDGET CARA ALLARD D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2008
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

4817 31ST ST S UNIT C-2
ARLINGTON VA
22206-1640
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-3664
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0116020728
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: