Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 26205 | MN |
NPI | 1154390417 |
---|---|
Provider Name | Dennis John Callahan |
First Address | Minneapolis, MN 55440-0043 |
Second Address | Coon Rapids, MN 55433-5841 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A94973 | (02) |