Provider Demographics
NPI:1528382736
Name:DURHAM, ALISON ADAMS (DPM)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:ADAMS
Last Name:DURHAM
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:PATRICE
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1852 BANKING ST
Mailing Address - Street 2:#9043
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7222
Mailing Address - Country:US
Mailing Address - Phone:336-338-7701
Mailing Address - Fax:
Practice Address - Street 1:1852 BANKING ST
Practice Address - Street 2:#9043
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7222
Practice Address - Country:US
Practice Address - Phone:919-260-6023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-16
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301054213E00000X, 213EP1101X
NC583213E00000X, 213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC9379C343Medicare PIN