Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | MD431222 | PA |
NPI | 1073728218 |
---|---|
Provider Name | Bonnie Catherine Callahan |
First Address | Philadelphia, PA 19147 |
Second Address | West Grove, PA 19390-9446 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 08/07/2007 |