Provider Demographics
NPI:1851579759
Name:JAMES E CALLAN MD PA
Entity Type:Organization
Organization Name:JAMES E CALLAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:CALLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-891-6133
Mailing Address - Street 1:7610 CARROLL AVE
Mailing Address - Street 2:#470
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6324
Mailing Address - Country:US
Mailing Address - Phone:301-891-6133
Mailing Address - Fax:301-891-6300
Practice Address - Street 1:7610 CARROLL AVE
Practice Address - Street 2:#470
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6324
Practice Address - Country:US
Practice Address - Phone:301-891-6133
Practice Address - Fax:301-891-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD24073207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA123632Medicare PIN
C61964Medicare UPIN
0178850001Medicare NSC