Provider Demographics
NPI:1780979856
Name:CALLOWAY, SEAN PATRICK (MD)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:PATRICK
Last Name:CALLOWAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:5255 E STOP 11 RD STE 300
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-6341
Practice Address - Country:US
Practice Address - Phone:317-528-4723
Practice Address - Fax:317-528-4699
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2022-12-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01078594A207X00000X, 207XX0005X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty