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General NPI Number Information
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NPI Number | 1083606461
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Entity Type | Individual
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Provider Name | HEATHER LEIGH CALLUM MD
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Gender | Female
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 05/07/2020
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Provider Practice Location Address
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Address Line | 508 UPLAND ST
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City | KENAI
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State | AK
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Zip | 99611-8026
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Country | US
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Telephone | 907-335-7510
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Fax | 888-491-3360
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Provider Business Mailing Address
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Address Line | 508 UPLAND ST
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City | KENAI
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State | AK
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Zip | 99611-8026
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Country | US
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Telephone | 907-335-7510
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Fax | 888-491-3360
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | D0050681
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License Number State | MD
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