Healthcare Provider Details

I. General information

NPI: 1831259027
Provider Name (Legal Business Name): DAVID PETER ALLISON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 MONTGOMERY BLVD NE SUITE 201
ALBUQUERQUE NM
87111-2468
US

IV. Provider business mailing address

905 SIERRA PL SE
ALBUQUERQUE NM
87108-3378
US

V. Phone/Fax

Practice location:
  • Phone: 505-298-2505
  • Fax:
Mailing address:
  • Phone: 505-268-2232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number95-5
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: