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General NPI Number Information
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NPI Number | 1063949030
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Entity Type | Individual
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Provider Name | JARED DAVID MCCALLUM MD
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Gender | Male
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Dates
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Enumeration Date | 05/22/2017
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 62-1262 DON MILLS RD
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City | NORTH YORK
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State | ONTARIO
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Zip | M3B 2W7
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Country | CA
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Telephone | 416-335-7474
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Fax |
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Provider Business Mailing Address
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Address Line | 5950 LASALLE ST
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City | LASALLE
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State | CANADA
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Zip | N9J3L6
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Country | CA
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | T-4582
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License Number State | MS
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