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General NPI Number Information
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NPI Number | 1245203678
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Entity Type | Individual
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Provider Name | ALLISON R DURICA MD
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Gender | Female
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 101 ELM AVE SE
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City | ROANOKE
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State | VA
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Zip | 24013-2222
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Country | US
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Telephone | 540-985-9985
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Fax |
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Provider Business Mailing Address
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Address Line | 213 S JEFFERSON ST STE 1006
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City | ROANOKE
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State | VA
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Zip | 24011-1713
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Country | US
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Telephone | 540-224-5715
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Fax | 540-224-5684
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101246473
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 0101246473
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License Number State | VA
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