Provider Demographics
NPI:1568773588
Name:CALLANDER, MATTHEW S (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:S
Last Name:CALLANDER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1414 W FAIR AVE
Mailing Address - Street 2:SUITE 36
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-2675
Mailing Address - Country:US
Mailing Address - Phone:906-225-3864
Mailing Address - Fax:906-225-3851
Practice Address - Street 1:1414 W FAIR AVE
Practice Address - Street 2:SUITE 36
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-2675
Practice Address - Country:US
Practice Address - Phone:906-225-3864
Practice Address - Fax:906-225-3851
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2017-07-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301096929208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist