Healthcare Provider Details

I. General information

NPI: 1265511372
Provider Name (Legal Business Name): PATRICIA MCDONALD ALLI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 SULPHUR SPRING RD
HALETHORPE MD
21227-2943
US

IV. Provider business mailing address

8 FAIRFIELD DR
CATONSVILLE MD
21228-5025
US

V. Phone/Fax

Practice location:
  • Phone: 410-536-1619
  • Fax:
Mailing address:
  • Phone: 410-744-5307
  • Fax: 410-536-1634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberD0056100
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: