Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0207X | Pediatric Hematology-Oncologist | 10514 | SD |
N | 2080P0207X | Pediatric Hematology-Oncologist | LP03247 | RI |
Y | 2080P0207X | Pediatric Hematology-Oncologist | MD24051 | ME |
NPI | 1134428899 |
---|---|
Provider Name | Dr. Daniel Lee Callaway |
First Address | Brewer, ME 04412-1006 |
Second Address | Brewer, ME 04412-1021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2011 |
Last Update Date | 22/10/2020 |