Healthcare Provider Details

I. General information

NPI: 1184309122
Provider Name (Legal Business Name): EVAN JAMES CALLAHAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2023
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 HIGHLAND ST
LACONIA NH
03246-3235
US

IV. Provider business mailing address

250 PLEASANT ST
CONCORD NH
03301-2598
US

V. Phone/Fax

Practice location:
  • Phone: 603-524-3211
  • Fax: 603-227-7574
Mailing address:
  • Phone: 603-227-7000
  • Fax: 603-230-7405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOT022669
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number40056
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: