Provider Demographics
NPI:1205956422
Name:MCALLISTER, SCOTT P (CP)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:P
Last Name:MCALLISTER
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:105 NEWSOM ST STE 105
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2197
Mailing Address - Country:US
Mailing Address - Phone:919-471-9891
Mailing Address - Fax:919-477-1235
Practice Address - Street 1:105 NEWSOM ST STE 105
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2197
Practice Address - Country:US
Practice Address - Phone:919-471-9891
Practice Address - Fax:919-477-1235
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Not Answered225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7795153Medicaid
NC7795026Medicaid