Individual
ALLIRIC I. WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 WALNUT ST, SUITE 500, PHILADELPHIA, PA 19107-5563
(215) 955-6750
(215) 823-8222
Mailing address
1100 WALNUT ST, SUITE 500, PHILADELPHIA, PA 19107-5563
(215) 955-6750
(215) 823-8222
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD424463
PA
2086X0206X
Surgical Oncology Physician
Primary
MD424463
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016680610001
—
PA
05
—
1016680610004
—
PA
01
—
1621481
PERSONAL CHOICE
PA
01
—
2298641000
KEYSTONE IBC
PA
01
—
30032812
KEYSTONE MERCY
PA
01
—
35488
HEALTH PARTNERS
PA
01
—
5810126
AETNA HMO
PA
01
—
P00385401
RAILROAD MEDICARE
PA
Enumeration date
07/07/2006
Last updated
08/17/2015
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