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General NPI Number Information
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NPI Number | 1508113564
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Entity Type | Organization
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Legal Business Name | DANIEL M CALLOWAY MD PA
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Dates
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Enumeration Date | 08/09/2012
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Last Update Date | 08/09/2012
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Provider Practice Location Address
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Address Line | 6000B-1 SAWGRASS VILLAGE CIR
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City | PONTE VEDRA
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State | FL
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Zip | 32082-5062
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Country | US
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Telephone | 904-273-8280
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Fax |
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Provider Business Mailing Address
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Address Line | 6000B-1 SAWGRASS VILLAGE CIR
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City | PONTE VEDRA
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State | FL
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Zip | 32082-5062
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Country | US
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Telephone | 904-273-8280
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/PLASTIC SURGEON
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Name | DANIEL MURRAY CALLOWAY
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Credential | MD
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Telephone | 904-273-8280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | ME64362
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License Number State | FL
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