Provider Demographics
NPI:1245203678
Name:DURICA, ALLISON R (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:R
Last Name:DURICA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 S JEFFERSON ST STE 1006
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24011-1713
Mailing Address - Country:US
Mailing Address - Phone:540-224-5715
Mailing Address - Fax:540-224-5684
Practice Address - Street 1:101 ELM AVE SE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24013-2222
Practice Address - Country:US
Practice Address - Phone:540-985-9985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101246473207V00000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1533459OtherGATEWAY-WMG
PA7826672OtherAETNA
PA001967193Medicaid
PA50058985OtherCAPITAL BLUE CROSS-WMG
PA1505416OtherHIGHMARK
PA3147337OtherMAMSI-WMG
PA101466OtherGEISINGER HEALTH PLAN
PA180477OtherUNISON-WMG
PA20053950OtherAMERIHEALTH MERCY-WMG
MD0091049-00Medicaid
PA203252OtherJOHNS HOPKINS
PA2193683000OtherAMERIHEALTH 65 PA
MD882265OtherCAREFIRST MD BCBS
MD882265OtherCAREFIRST MD BCBS
MD0091049-00Medicaid