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NPI Code Detail

MEDICARE: GREGORY CALLANAN DO

MEDICARE: GREGORY CALLANAN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XS0117XOrthopaedic Surgery of the Spine Physician25MB11717700NJ
2207X00000XOrthopaedic Surgery Physician25MB11717700NJ
3390200000XStudent in an Organized Health Care Education/Training Program
4207X00000XOrthopaedic Surgery PhysicianOS021856PA

General Provider Information

NPI Number : 1831625789
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY CALLANAN DO
Provider Business Mailing Address
First Line : 301 LIPPINCOTT DR STE 410
Second Line :
City : MARLTON
State : NJ
Zip : 08053-4197
Country : US
Telephone Number : 609-267-9400
Fax Number : 609-927-1616
Provider Business Practice Location Address
First Line : 547 NEW RD
Second Line :
City : SOMERS POINT
State : NJ
Zip : 08244-2038
Country : US
Telephone Number : 609-267-9400
Fax Number : 609-927-1616
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2017
Last Update Date : 05/19/2026

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