Provider Demographics
NPI:1295724623
Name:LALOR, ALLEN W (MD)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:W
Last Name:LALOR
Suffix:
Gender:M
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:PO BOX 15268
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28813-0268
Mailing Address - Country:US
Mailing Address - Phone:828-250-2833
Mailing Address - Fax:828-665-8275
Practice Address - Street 1:445 BILTMORE AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4565
Practice Address - Country:US
Practice Address - Phone:828-213-4600
Practice Address - Fax:828-213-4711
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36109207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8950671Medicaid
NC2183152HMedicare ID - Type Unspecified
NC8950671Medicaid