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General NPI Number Information
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NPI Number | 1114189651
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Entity Type | Individual
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Provider Name | STEVEN SCOTT MCCALLISTER MD
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Gender | Male
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 134 COOLIDGE AVE
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City | WATERTOWN
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State | MA
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Zip | 02472-2815
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Country | US
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Telephone | 617-779-5514
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Fax |
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Provider Business Mailing Address
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Address Line | 5 WALNUT ST
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City | LEXINGTON
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State | MA
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Zip | 02421-8219
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Country | US
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Telephone | 617-744-0178
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 039164
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License Number State | CT
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