Provider Demographics
NPI:1124285572
Name:LUDDY, ALYSSA COWELL (MD)
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:COWELL
Last Name:LUDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 HOSPICE CIR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6372
Mailing Address - Country:US
Mailing Address - Phone:919-828-0890
Mailing Address - Fax:978-774-4389
Practice Address - Street 1:250 HOSPICE CIR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6372
Practice Address - Country:US
Practice Address - Phone:919-828-0890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2022-01675207Q00000X
OR126246207QH0002X
CAA122587207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine