Provider Demographics
NPI:1114975406
Name:LYNCH, ALISON M (MD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:M
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:M
Other - Last Name:STORRAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:151 BREEZY POINT DR
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:VA
Mailing Address - Zip Code:23692-3317
Mailing Address - Country:US
Mailing Address - Phone:757-890-0620
Mailing Address - Fax:
Practice Address - Street 1:1300 E MARSHALL ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-0710
Practice Address - Country:US
Practice Address - Phone:804-628-1768
Practice Address - Fax:804-828-4614
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010429592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
C51806Medicare UPIN