Individual
DR. ROBERT EDWARD MCCALLISTER
Active
Individual
DR. ROBERT EDWARD MCCALLISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
01030428
IN
207ND0900X
Dermatopathology Physician
01030428
IN
207NP0225X
Pediatric Dermatology Physician
01030428
IN
207NS0135X
Procedural Dermatology Physician
01030428
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000087049
ANTHEM PROVIDER NUMBER
IN
01
—
0004359769
AETNA
IN
01
—
070001836
RAILROAD MEDICARE
IN
01
—
351711573
TAX IDENTIFICATION NUMBER
IN
Enumeration date
05/24/2005
Last updated
11/23/2010
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