Provider Demographics
NPI:1588179162
Name:MCALLISTER, ANDRE JERMAINE (CSA)
Entity type:Individual
Prefix:MR
First Name:ANDRE
Middle Name:JERMAINE
Last Name:MCALLISTER
Suffix:
Gender:M
Credentials:CSA
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Mailing Address - Street 1:8486 CAMPBELLTON ST # 392
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-1819
Mailing Address - Country:US
Mailing Address - Phone:470-234-1117
Mailing Address - Fax:470-410-4419
Practice Address - Street 1:3195 MARTHA CT
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-8145
Practice Address - Country:US
Practice Address - Phone:470-234-1117
Practice Address - Fax:470-410-4419
Is Sole Proprietor?:No
Enumeration Date:2017-12-05
Last Update Date:2025-07-15
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Provider Licenses
StateLicense IDTaxonomies
GA246ZC0007X
GA4854246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant