Provider Demographics
NPI:1780668533
Name:MCCALL, SEAN P (DO)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:P
Last Name:MCCALL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-071-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:531 MT PLEASANT DR
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1987
Practice Address - Country:US
Practice Address - Phone:570-342-8500
Practice Address - Fax:570-558-2290
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2020-08-21
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Provider Licenses
StateLicense IDTaxonomies
PAOS009911L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001777573Medicaid
PA001777573Medicaid
PAP00033531Medicare PIN
PA033098NW4Medicare PIN