Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 01036319A | IN |
N | 111NI0900X | Internist | 01036319A | IN |
Y | 207RG0300X | Geriatric Medicine | 01036319A | IN |
NPI | 1104867043 |
---|---|
Provider Name | Christopher M Callahan |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-1476 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2006 |
Last Update Date | 18/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000086850 | ANTHEM (01) | IN |
100068500 | (05) | IN |
D46980 | (02) | IN |