MEDICARE: MR. THOMAS MICHAEL CALLAHAN NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	79053	NC

General Provider Information

NPI Number	:	1053394957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS MICHAEL CALLAHAN NP

Provider Business Mailing Address
First Line	:	1309 N ELM STREET
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401
Country	:	US
Telephone Number	:	336-544-5400
Fax Number	:	336-544-5401

Provider Business Practice Location Address
First Line	:	1309 N ELM STREET
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401
Country	:	US
Telephone Number	:	336-544-5400
Fax Number	:	336-544-5401

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	02/15/2026

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