Provider Demographics
NPI:1164102356
Name:CALLAWAY, CAPATHYIA S
Entity Type:Individual
Prefix:MS
First Name:CAPATHYIA
Middle Name:S
Last Name:CALLAWAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7014 SMITH CORNERS BLVD # 1296
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-3793
Mailing Address - Country:US
Mailing Address - Phone:704-608-1123
Mailing Address - Fax:
Practice Address - Street 1:12435 OLD STATEVILLE ROAD
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078
Practice Address - Country:US
Practice Address - Phone:704-608-1123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle