Doctor Name: | DR. DANIEL LEE CALLAWAY |
NPI Number: | 1134428899 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 593 Eddy St Multiphasic Building, 1st Floor Providence, RI - 029034923 |
Business Phone Number: | 4014445171 |
Business Fax Number: | 4014448845 |
Mailing Address: | 593 Eddy St, Multiphasic Building, 1st Floor PROVIDENCE |
State: | RI |
Postal Code: | 029034923 |
Phone Number: | 4014445171 |
Fax Number: | 4014448845 |
NPI Enumeration Date: | 03/21/2011 |
NPI Last Update Date: | 03/17/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |