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Individual
BRADLEY J MCALLISTER
Active
Individual
BRADLEY J MCALLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
185405-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001563700
—
ID
05
—
002083525
—
WY
01
—
107005855101
IHC
UT
01
—
1502954
UMWA
UT
01
—
2090168
UNITED HEALTHCARE
UT
01
—
37804
PEHP
UT
01
—
53254
HEALTHY U
UT
05
—
820648
—
AZ
01
—
8597445
WORKERS COMP
UT
01
—
870545614MC1
EDUCATORS MUTUAL
UT
01
—
PRA01569
MOLINA
UT
01
—
QM0000075886
ALTIUS
UT
Enumeration date
08/30/2006
Last updated
10/15/2012
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