Provider Demographics
NPI:1962673657
Name:VALENTINE, ALLISON MARIE (MD)
Entity type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:MARIE
Last Name:VALENTINE
Suffix:
Gender:
Credentials:MD
Other - Prefix:MRS
Other - First Name:ALLISON
Other - Middle Name:VALENTINE
Other - Last Name:LAXTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4625 LINDELL BLVD STE 224
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-3725
Mailing Address - Country:US
Mailing Address - Phone:919-914-9989
Mailing Address - Fax:919-910-6679
Practice Address - Street 1:112 TRACY TRL
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27712-3445
Practice Address - Country:US
Practice Address - Phone:919-914-9989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA325134207Q00000X
NC201300757207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine