Provider Demographics
NPI:1114008075
Name:CALLANS, LINDA S (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:S
Last Name:CALLANS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 CALVERT RD
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1533
Mailing Address - Country:US
Mailing Address - Phone:610-771-0397
Mailing Address - Fax:
Practice Address - Street 1:2100 KEYSTONE AVE
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-1129
Practice Address - Country:US
Practice Address - Phone:610-394-1840
Practice Address - Fax:610-394-1845
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043768E2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA745364Medicare ID - Type Unspecified
PAF57188Medicare UPIN