Physician Compare National (NPI:1982671723)

HEALTHCARE PROVIDER: STEWART JAMES CALLIS MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1982671723
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1456413590
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20081223000554
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CALLIS
	Individual professional last name
Provider First Name	STEWART
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	317 E OAK ST
	Group Practice or individual's line 1 address
City	OAKLAND
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	215501503
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3013345281
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	210017
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GARRETT COUNTY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	M