Provider Demographics
NPI:1518588482
Name:MARY ELIZABETH MCALLISTER, LLC
Entity type:Organization
Organization Name:MARY ELIZABETH MCALLISTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MCALLISTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-370-8707
Mailing Address - Street 1:5 BELLEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-4845
Mailing Address - Country:US
Mailing Address - Phone:443-370-8707
Mailing Address - Fax:
Practice Address - Street 1:130 ADMIRAL COCHRANE DR STE 300
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7373
Practice Address - Country:US
Practice Address - Phone:443-370-8707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-02
Last Update Date:2020-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty