Provider Demographics
NPI:1093782286
Name:CALLAHAN, DANIEL F JR (DPM)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:F
Last Name:CALLAHAN
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:873 TURNPIKE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845
Mailing Address - Country:US
Mailing Address - Phone:978-681-0406
Mailing Address - Fax:978-975-7148
Practice Address - Street 1:873 TURNPIKE ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845
Practice Address - Country:US
Practice Address - Phone:978-681-0406
Practice Address - Fax:978-975-7148
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1695213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0350907Medicaid
MAY70750OtherBCBS
NH0308286YOMA01OtherBCBS
MAY70750Medicare ID - Type Unspecified
MA0350907Medicaid