MEDICARE: MR. MARK LAWRENCE CALLAHAN SLP

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	235Z00000X	Speech-Language Pathologist	SL003238L	PA

General Provider Information

NPI Number	:	1215194915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARK LAWRENCE CALLAHAN SLP

Provider Business Mailing Address
First Line	:	6000 BABCOCK BLVD
Second Line	:	SUITE 1002
City	:	PITTSBURGH
State	:	PA
Zip	:	15237-2564
Country	:	US
Telephone Number	:	412-369-5150
Fax Number	:	412-369-5163

Provider Business Practice Location Address
First Line	:	6000 BABCOCK BLVD
Second Line	:	SUITE 1002
City	:	PITTSBURGH
State	:	PA
Zip	:	15237-2564
Country	:	US
Telephone Number	:	412-369-5150
Fax Number	:	412-369-5163

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

Provider Enumeration Date	:	05/20/2008
Last Update Date	:	05/20/2008

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Directions to “ MR. MARK LAWRENCE CALLAHAN SLP” Practice Location

Language	Start Address	Practice Location

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