Provider Demographics
NPI:1295774941
Name:CALLMAN, MARK L (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:L
Last Name:CALLMAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2525 HARBOR BLVD
Mailing Address - Street 2:104
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-5317
Mailing Address - Country:US
Mailing Address - Phone:941-629-5757
Mailing Address - Fax:941-629-7404
Practice Address - Street 1:2525 HARBOR BLVD
Practice Address - Street 2:104
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-5317
Practice Address - Country:US
Practice Address - Phone:941-629-5757
Practice Address - Fax:941-629-7404
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2014-07-09
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Provider Licenses
StateLicense IDTaxonomies
FLME38329207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL08101Medicare ID - Type Unspecified
FLD51981Medicare UPIN