Provider Demographics
NPI:1831259027
Name:ALLISON, DAVID PETER (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PETER
Last Name:ALLISON
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 1:905 SIERRA PL SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-3378
Mailing Address - Country:US
Mailing Address - Phone:505-268-2232
Mailing Address - Fax:
Practice Address - Street 1:9201 MONTGOMERY BLVD NE
Practice Address - Street 2:SUITE 201
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2468
Practice Address - Country:US
Practice Address - Phone:505-298-2505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM95-5208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics