Provider Demographics
NPI:1215108063
Name:CREPEAU, ALLISON ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:ELIZABETH
Last Name:CREPEAU
Suffix:
Gender:
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 741593
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1593
Mailing Address - Country:US
Mailing Address - Phone:757-668-8544
Mailing Address - Fax:757-668-6544
Practice Address - Street 1:399 FARMINGTON AVE STE 300
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1979
Practice Address - Country:US
Practice Address - Phone:860-837-9220
Practice Address - Fax:860-837-9221
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101251650207X00000X
CT63691207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10095256OtherOPTIMA
VA311610834OtherMAMSI
VA311610834OtherMDIPA
VA9328958OtherCIGNA
VA1215108063OtherMEDICARE
VA311610834OtherTRICARE
VA311610834OtherBEECH STREET
VA1215108063OtherVA. PREMIER
VA311610834OtherVHN
VA1512108063OtherMULTIPLAN
VA311610834OtherUHC
VA1215108063OtherAETNA
VA1215108063OtherANTHEM
NC1215108063Medicaid
VA1215108063Medicaid