Provider Demographics
NPI:1427048370
Name:MC ALLISTER, MICHAEL R (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:R
Last Name:MC ALLISTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 SPEEDWELL FORGE RD
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-9484
Mailing Address - Country:US
Mailing Address - Phone:215-534-9077
Mailing Address - Fax:
Practice Address - Street 1:630 SPEEDWELL FORGE RD
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-9484
Practice Address - Country:US
Practice Address - Phone:215-534-9077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005523L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry