Provider Demographics
NPI:1851596761
Name:WILMOT, ALISSA COWDEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALISSA
Middle Name:COWDEN
Last Name:WILMOT
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 1:210 CHAUCER CT S
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-8726
Mailing Address - Country:US
Mailing Address - Phone:302-332-8808
Mailing Address - Fax:
Practice Address - Street 1:155 WILSON AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-3336
Practice Address - Country:US
Practice Address - Phone:302-332-8808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT190144208000000X
PAMD451001207L00000X
PAMT 190144207L00000X
DEC10009739207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics