Healthcare Provider Details

I. General information

NPI: 1912535543
Provider Name (Legal Business Name): ALLISON ROSE DURHAM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON KIRKPATRICK

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 MILFORD ST STE 101
SALISBURY MD
21804-6966
US

IV. Provider business mailing address

106 MILFORD ST STE 101
SALISBURY MD
21804-6966
US

V. Phone/Fax

Practice location:
  • Phone: 410-742-1567
  • Fax: 410-742-1906
Mailing address:
  • Phone: 410-742-1567
  • Fax: 410-742-1906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberD0103623
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: