Individual
DR. ALLEN WILSON DITTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13620 CRAYTON BOULEVARD, HAGERSTOWN, MD 21742
(240) 313-9890
(240) 313-9890
Mailing address
P O BOX 412047, BOSTON, MA 02241
(301) 790-9044
(301) 790-9096
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D26806
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256671100
—
MD
Enumeration date
06/15/2005
Last updated
11/27/2018
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