Provider Demographics
NPI:1437145604
Name:ALLISON, TREVOR ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:ROBERT
Last Name:ALLISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-637-1123
Mailing Address - Fax:704-637-1214
Practice Address - Street 1:401 MOCKSVILLE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2735
Practice Address - Country:US
Practice Address - Phone:704-637-1123
Practice Address - Fax:704-637-1214
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200100635207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89129W1Medicaid
NCH37809Medicare UPIN
NC89129W1Medicaid