Individual
DR. MARTY L ALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 945-5246
(605) 945-5295
Mailing address
100 MAC LANE, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 945-5246
(605) 945-5295
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4425
SD
208000000X
Pediatrics Physician
Primary
SD4425
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6701220
—
SD
05
—
6701223
—
SD
Enumeration date
02/15/2006
Last updated
04/10/2012
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