Provider Demographics
NPI:1962673657
Name:VALENTINE, ALLISON MARIE (MD)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:MARIE
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:ALLISON
Other - Middle Name:VALENTINE
Other - Last Name:LAXTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2523 DELANEY AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6003
Mailing Address - Country:US
Mailing Address - Phone:910-772-9202
Mailing Address - Fax:910-772-9452
Practice Address - Street 1:2523 DELANEY AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6003
Practice Address - Country:US
Practice Address - Phone:910-772-9202
Practice Address - Fax:910-772-9452
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201300757207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine