Healthcare Provider Details

I. General information

NPI: 1932117678
Provider Name (Legal Business Name): G SEAN CALLENDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 02/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 MAIN ST
NORWAY ME
04268-5664
US

IV. Provider business mailing address

PO BOX 460
PERU ME
04290-0460
US

V. Phone/Fax

Practice location:
  • Phone: 207-743-5933
  • Fax: 207-393-3128
Mailing address:
  • Phone: 207-357-8786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number017185
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD17185
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: