Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | MD043768E | PA |
NPI | 1114008075 |
---|---|
Provider Name | Dr. Linda S Callans |
First Address | Merion Station, PA 19066-1533 |
Second Address | Drexel Hill, PA 19026-1129 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F57188 | (02) | PA |