Healthcare Provider Details

I. General information

NPI: 1003747163
Provider Name (Legal Business Name): JOSEPH MCCALLION
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: J. D. MCCALLION

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 IRONMASTER DR
THURMONT MD
21788-3141
US

IV. Provider business mailing address

119 IRONMASTER DR
THURMONT MD
21788-3141
US

V. Phone/Fax

Practice location:
  • Phone: 240-674-4180
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number10277291520
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: