Provider Demographics
NPI:1841298809
Name:EVANS-WOOD, ALLISON L (DO)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:L
Last Name:EVANS-WOOD
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 1:17204 MCMULLEN HWY SW
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-6214
Mailing Address - Country:US
Mailing Address - Phone:301-729-0060
Mailing Address - Fax:301-729-3100
Practice Address - Street 1:17204 MCMULLEN HWY SW
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-6214
Practice Address - Country:US
Practice Address - Phone:301-729-0060
Practice Address - Fax:301-729-3100
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2011-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0056080207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H32902Medicare UPIN