Provider Demographics
NPI:1699237057
Name:HALDERMAN, ALLYSON K (DO)
Entity type:Individual
Prefix:MRS
First Name:ALLYSON
Middle Name:K
Last Name:HALDERMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 SOUTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-1221
Mailing Address - Country:US
Mailing Address - Phone:937-395-6010
Mailing Address - Fax:
Practice Address - Street 1:700 S STANFIELD RD STE A
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-2569
Practice Address - Country:US
Practice Address - Phone:937-339-5535
Practice Address - Fax:937-702-4039
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.015864208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist