Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 260054 | MA |
Y | 207V00000X | Obstetrician & Gynecologist | A150023 | CA |
N | 207VE0102X | Reproductive Endocrinologist | 260054 | MA |
NPI | 1144506643 |
---|---|
Provider Name | Ryan James Callery |
First Address | Boston, MA 02241-5348 |
Second Address | Stockton, CA 95210-3377 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2011 |
Last Update Date | 17/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110100388A | (05) | MA |