Individual
MICHAEL CALLAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1055 N 500 W, PROVO, UT 84604-3305
(801) 763-3885
(801) 763-3887
Mailing address
1055 N 500 W, CREDENTIALING DEPARTMENT, PROVO, UT 84604-3305
(801) 354-8225
(801) 429-8180
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
160421-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09-00529
UNITED HEALTHCARE
UT
01
—
107006256103
IHC
UT
01
—
215835
ALTIUS
UT
01
—
3362695
CIGNA
UT
01
—
36397
DMBA
UT
01
—
78392
PEHP
UT
05
—
870281028000
—
UT
01
—
P00124656
PALMETTO GBA
—
Enumeration date
06/04/2006
Last updated
10/22/2007
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