Individual
JULIE N MCCALLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4607 MACCORKLE AVE SW, STE 400, SOUTH CHARLESTON, WV 25309-1364
(304) 766-4400
(304) 766-4417
Mailing address
4607 MACCORKLE AVE, STE 400, SOUTH CHARLESTON, WV 25309
(304) 766-4400
(304) 766-4417
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
23689
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810015753
—
WV
Enumeration date
05/09/2007
Last updated
03/06/2024
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