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NPI Code Detail

MEDICARE: MR. JOHN M CALLAHAN MD

MEDICARE: MR. JOHN M CALLAHAN MD
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
1207R00000XInternal Medicine Physician208546NY
2208M00000XHospitalist Physician208546NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00927986OTHERNYRAILROAD MEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568454528
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN M CALLAHAN MD
Provider Business Mailing Address
First Line : 301 PROSPECT AVE
Second Line : HOSPITAL INTERNISTS
City : SYRACUSE
State : NY
Zip : 13203-1807
Country : US
Telephone Number : 315-448-5704
Fax Number : 315-423-6853
Provider Business Practice Location Address
First Line : 301 PROSPECT AVE
Second Line : HOSPITAL INTERNISTS
City : SYRACUSE
State : NY
Zip : 13203-1807
Country : US
Telephone Number : 315-448-5704
Fax Number : 315-423-6853
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2005
Last Update Date : 04/08/2013

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