Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 034572 | CT |
NPI | 1386608990 |
---|---|
Provider Name | Robert W Mcallister |
First Address | Rocky Hill, CT 06067-3455 |
Second Address | Rocky Hill, CT 06067 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 26/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1345728 | (05) | CT |
F83928 | (02) | CT |