Provider Demographics
NPI:1205889870
Name:D'ALLURA, SAL A (DO, FAAFP)
Entity type:Individual
Prefix:DR
First Name:SAL
Middle Name:A
Last Name:D'ALLURA
Suffix:
Gender:M
Credentials:DO, FAAFP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 QUAKER LN
Mailing Address - Street 2:STE. 207C
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-3832
Mailing Address - Country:US
Mailing Address - Phone:336-883-2500
Mailing Address - Fax:
Practice Address - Street 1:1720 WESTCHESTER DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7285
Practice Address - Country:US
Practice Address - Phone:336-883-4296
Practice Address - Fax:336-883-2615
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-5443207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000185244OtherUNISON MEDICAID
1205889870OtherNPI
OH732291OtherBUCKEYE
000000484511OtherANTHEM BCBS
OH0864346Medicaid
OH000000523218OtherBCBS PUTNAM
OH000000523467OtherBCBS GREENVILLE
WV3810003573Medicaid
OH000000523218OtherBCBS PUTNAM
1205889870OtherNPI
OH4173453Medicare PIN
000000484511OtherANTHEM BCBS
OH0864346Medicaid