MEDICARE: JOHN MCALLISTER II MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	C10004126	DE

General Provider Information

NPI Number	:	1609877026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN MCALLISTER II MD

Provider Business Mailing Address
First Line	:	281 101ST ST
Second Line	:
City	:	STONE HARBOR
State	:	NJ
Zip	:	08247-1824
Country	:	US
Telephone Number	:	609-368-6262
Fax Number	:

Provider Business Practice Location Address
First Line	:	281 101ST ST
Second Line	:
City	:	STONE HARBOR
State	:	NJ
Zip	:	08247-1824
Country	:	US
Telephone Number	:	609-368-6262
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	03/19/2008

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