Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 37061 | SC |
NPI | 1043505670 |
---|---|
Provider Name | Sean P Callahan |
First Address | Greenville, SC 29601-2842 |
Second Address | Greenville, SC 29615-6338 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2011 |
Last Update Date | 10/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
370618 | (05) | SC |