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Individual
DR. MATTHEW D CALLISTER
Active
Individual
DR. MATTHEW D CALLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
32639
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
855471
—
AZ
01
—
86080015085054B049
TRIWEST
AZ
01
—
86080015085259C434
TRIWEST
AZ
01
—
P00187177
RAILROAD MEDICARE
AZ
Enumeration date
11/17/2005
Last updated
11/03/2011
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