Healthcare Provider Details

I. General information

NPI: 1306860176
Provider Name (Legal Business Name): WILLIAM E. CALLAGHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 W 21ST ST FL 2
NORFOLK VA
23517-1516
US

IV. Provider business mailing address

PO BOX 639971
CINCINNATI OH
45263-9971
US

V. Phone/Fax

Practice location:
  • Phone: 757-624-1785
  • Fax: 757-624-1759
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number027974
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number22928
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101035950
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: