MEDICARE: ANDREW CALLIGAN

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1568225100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW CALLIGAN

Provider Business Mailing Address
First Line	:	13342 MAGNOLIA CREEK TRL
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46814-5504
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13342 MAGNOLIA CREEK TRL
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46814-5504
Country	:	US
Telephone Number	:	260-498-9399
Fax Number	:

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

Provider Enumeration Date	:	02/05/2024
Last Update Date	:	02/05/2024

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Directions to “ ANDREW CALLIGAN ” Practice Location

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