Provider Demographics
NPI:1679992606
Name:FERREIRA, ALLISON OLIVIA (DO)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:OLIVIA
Last Name:FERREIRA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:OLIVIA
Other - Last Name:BACKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12605 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2545
Practice Address - Country:US
Practice Address - Phone:720-848-6198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH16799926062085R0202X
MN652372085R0202X
CODR.00682622085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN65237OtherMEDICAL LICENSE