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1205880507

NPI Code Detail

MEDICARE: MAUREEN ANN CALLAGHAN M.D.

MEDICARE: MAUREEN ANN CALLAGHAN M.D.

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	2084H0002X	Hospice and Palliative Medicine (Psychiatry & Neurology) Physician	MD00020274	WA
2	2084N0400X	Neurology Physician	MD00020274	WA
3	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	MD00020274	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205880507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN ANN CALLAGHAN M.D.

Provider Business Mailing Address
First Line	:	2901 BRIDGEPORT WAY W
Second Line	:
City	:	UNIVERSITY PLACE
State	:	WA
Zip	:	98466-4614
Country	:	US
Telephone Number	:	253-534-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2901 BRIDGEPORT WAY W
Second Line	:
City	:	UNIVERSITY PLACE
State	:	WA
Zip	:	98466-4614
Country	:	US
Telephone Number	:	253-534-7000
Fax Number	:

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

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	12/02/2020

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Directions to “ MAUREEN ANN CALLAGHAN M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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