Provider Demographics
NPI:1891773149
Name:MALL, ALISON L (MD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:L
Last Name:MALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:611 MITCHELL WAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-5441
Mailing Address - Country:US
Mailing Address - Phone:303-269-2780
Mailing Address - Fax:303-269-2790
Practice Address - Street 1:611 MITCHELL WAY
Practice Address - Street 2:SUITE 103
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-5441
Practice Address - Country:US
Practice Address - Phone:303-269-2780
Practice Address - Fax:303-269-2790
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2013-10-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA33025207V00000X
CODR.0039729207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology