Provider Demographics
NPI:1184627770
Name:CALLAHAN, DANIEL (DPM)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:CALLAHAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2290 LAKEVIEW DR
Mailing Address - Street 2:STE B
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-2576
Mailing Address - Country:US
Mailing Address - Phone:937-320-9954
Mailing Address - Fax:
Practice Address - Street 1:2290 LAKEVIEW DR
Practice Address - Street 2:STE B
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-2576
Practice Address - Country:US
Practice Address - Phone:937-320-9954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-002571213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery