Provider Demographics
NPI:1861457079
Name:CALLAWAY, GAIL M (MD)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:M
Last Name:CALLAWAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GAIL
Other - Middle Name:M
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:22911 JEFFERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:SMITHSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21783-1617
Mailing Address - Country:US
Mailing Address - Phone:301-824-3343
Mailing Address - Fax:301-824-6323
Practice Address - Street 1:22911 JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:SMITHSBURG
Practice Address - State:MD
Practice Address - Zip Code:21783-1617
Practice Address - Country:US
Practice Address - Phone:301-824-3343
Practice Address - Fax:301-824-6323
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0057600207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD755703500Medicaid
MD867EMedicare ID - Type Unspecified
MD755703500Medicaid