Provider Demographics
NPI:1689871873
Name:MALLOY, ALLISON MW (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:MW
Last Name:MALLOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALLISON
Other - Middle Name:M
Other - Last Name:WAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4301 JONES BRIDGE RD
Mailing Address - Street 2:DEPARTMENT OF PEDIATRICS
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4712
Mailing Address - Country:US
Mailing Address - Phone:301-295-9728
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:WALTER REED NATIONAL MILITARY MEDICAL CENTER
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5600
Practice Address - Country:US
Practice Address - Phone:301-295-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT186203208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics