Provider Demographics
NPI:1023837820
Name:MACALLAN, DAVID GERALD ALEXANDER (NMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GERALD ALEXANDER
Last Name:MACALLAN
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6770 W ST RTE 89A UNIT 177
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-9504
Mailing Address - Country:US
Mailing Address - Phone:949-212-7775
Mailing Address - Fax:
Practice Address - Street 1:6770 W ST RTE 89A UNIT 177
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-9504
Practice Address - Country:US
Practice Address - Phone:949-212-7775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ97-492175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath