Basic Information
| Provider Information | |||||||||
| NPI: | 1245203678 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DURICA | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 213 S JEFFERSON ST STE 1006 | ||||||||
| Address2: | |||||||||
| City: | ROANOKE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 240111713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5402245715 | ||||||||
| FaxNumber: | 5402245684 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 ELM AVE SE | ||||||||
| Address2: | |||||||||
| City: | ROANOKE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 240132222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5409859985 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2006 | ||||||||
| LastUpdateDate: | 08/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 0101246473 | VA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VM0101X | 0101246473 | VA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1533459 | 01 | PA | GATEWAY-WMG | OTHER | 7826672 | 01 | PA | AETNA | OTHER | 001967193 | 05 | PA | MEDICAID | 50058985 | 01 | PA | CAPITAL BLUE CROSS-WMG | OTHER | 1505416 | 01 | PA | HIGHMARK | OTHER | 3147337 | 01 | PA | MAMSI-WMG | OTHER | 101466 | 01 | PA | GEISINGER HEALTH PLAN | OTHER | 180477 | 01 | PA | UNISON-WMG | OTHER | 20053950 | 01 | PA | AMERIHEALTH MERCY-WMG | OTHER | 0091049-00 | 05 | MD | MEDICAID | 203252 | 01 | PA | JOHNS HOPKINS | OTHER | 2193683000 | 01 | PA | AMERIHEALTH 65 PA | OTHER | 882265 | 01 | MD | CAREFIRST MD BCBS | OTHER |