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NPI Code Detail

MEDICARE: ALLISON MAILLIARD

MEDICARE: ALLISON MAILLIARD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianOS012057PA

General Provider Information

NPI Number : 1245253129
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON MAILLIARD
Provider Business Mailing Address
First Line : 7287 W RIDGE RD
Second Line :
City : FAIRVIEW
State : PA
Zip : 16415-1130
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7287 W RIDGE RD
Second Line :
City : FAIRVIEW
State : PA
Zip : 16415-1130
Country : US
Telephone Number : 814-877-2360
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2006
Last Update Date : 03/25/2021

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Directions to “ ALLISON MAILLIARD ” Practice Location

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