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NPI Code Detail

MEDICARE: MEGAN CALLAHAN OD

MEDICARE:   MEGAN  CALLAHAN  OD
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
1390200000XStudent in an Organized Health Care Education/Training Program
2152W00000XOptometristOPT.0003717CO

General Provider Information

NPI Number : 1073189114
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN CALLAHAN OD
Provider Business Mailing Address
First Line : 1950 OLD GALLOWS RD STE 520
Second Line :
City : VIENNA
State : VA
Zip : 22182-3970
Country : US
Telephone Number : 703-847-8899
Fax Number : 571-223-6780
Provider Business Practice Location Address
First Line : 200 W COUNTY LINE RD STE 150
Second Line :
City : HIGHLANDS RANCH
State : CO
Zip : 80129-2361
Country : US
Telephone Number : 303-794-2433
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2021
Last Update Date : 06/29/2021

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