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Individual

DR. SCOTT HORTON MCCALLISTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3600 KOLBE RD, SUITE 127, LORAIN, OH 44053-1654
(440) 414-9200
(216) 201-5582
Mailing address
3600 KOLBE RD, SUITE 127, LORAIN, OH 44053-1654
(440) 414-9200
(216) 201-5582

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35072766
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000128726
ANTHEM
OH
01
060046929
RAILROAD MEDICARE
01
100412
KAISER
OH
05
2030439
OH
01
341221800061
CARESOURCE
OH
01
E72766
SUMMACARE
OH
Enumeration date
01/13/2006
Last updated
01/07/2021
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