Provider Demographics
NPI:1932117678
Name:CALLENDER, G SEAN (MD)
Entity Type:Individual
Prefix:
First Name:G
Middle Name:SEAN
Last Name:CALLENDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 460
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:ME
Mailing Address - Zip Code:04290-0460
Mailing Address - Country:US
Mailing Address - Phone:207-357-8786
Mailing Address - Fax:
Practice Address - Street 1:181 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWAY
Practice Address - State:ME
Practice Address - Zip Code:04268-5664
Practice Address - Country:US
Practice Address - Phone:207-743-5933
Practice Address - Fax:207-393-3128
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME017185207Q00000X
MEMD17185208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEI42798Medicare UPIN