Provider Demographics
NPI:1780751040
Name:MICHAEL A CALLAHAN MD & ASSOCIATES PC
Entity type:Organization
Organization Name:MICHAEL A CALLAHAN MD & ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:HUNTER
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:ABOC
Authorized Official - Phone:205-933-6888
Mailing Address - Street 1:700 18TH ST S
Mailing Address - Street 2:SUITE 711
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-3806
Mailing Address - Country:US
Mailing Address - Phone:205-933-6888
Mailing Address - Fax:
Practice Address - Street 1:700 18TH ST S
Practice Address - Street 2:SUITE 711
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-3806
Practice Address - Country:US
Practice Address - Phone:205-933-6888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00006083207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL528500580Medicaid
AL528500580Medicaid
AL1063421261Medicare NSC
AL1902892151Medicare NSC
AL1033105283Medicare NSC
ALE376Medicare ID - Type Unspecified
AL1760478226Medicare NSC