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General NPI Number Information
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NPI Number | 1336521673
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Entity Type | Organization
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Legal Business Name | CALLMAN INTERNAL MEDICINE
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Dates
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Enumeration Date | 06/23/2015
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Last Update Date | 06/23/2015
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Provider Practice Location Address
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Address Line | 21281 GRAYTON TER D JACOBSON VA NH
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City | PORT CHARLOTTE
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State | FL
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Zip | 33954-3109
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Country | US
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Telephone | 941-206-5200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 495009
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City | PORT CHARLOTTE
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State | FL
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Zip | 33949-5009
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Country | US
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Telephone | 941-206-5200
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Fax | 941-206-3322
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK L CALLMAN
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Credential | MD
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Telephone | 941-206-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME38329
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License Number State | FL
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