Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | DOS719 | HI |
NPI | 1295823557 |
---|---|
Provider Name | Dr. Charles Willis Callahan |
First Address | Silver Spring, MD 20904-1234 |
Second Address | Washington, DC 20907-1234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 08/07/2007 |