Individual
DR. MATTHEW D CALLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2940 E BANNER GATEWAY DR, SUITE 450, GILBERT, AZ 85234-2168
(480) 256-6444
Mailing address
2940 E BANNER GATEWAY DR, SUITE 450, GILBERT, AZ 85234-2168
(480) 256-6444
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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