MEDICARE: ALLISON MCCRORY M.D.

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
1	207Y00000X	Otolaryngology Physician	38774	TN
2	207N00000X	Dermatology Physician	MD19205	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992753743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON MCCRORY M.D.

Provider Business Mailing Address
First Line	:	50 SEWALL ST
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04102-2645
Country	:	US
Telephone Number	:	207-775-3526
Fax Number	:	207-775-5658

Provider Business Practice Location Address
First Line	:	50 SEWALL ST
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04102-2645
Country	:	US
Telephone Number	:	207-775-3526
Fax Number	:	207-775-5658

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	06/18/2012

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Directions to “ ALLISON MCCRORY M.D.” Practice Location

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