Individual
MRS. CECILIA MARIBEE MACCALLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1701 THOMSON DR, SUITE 200, LYNCHBURG, VA 24501-1118
(434) 200-5925
(434) 200-5929
Mailing address
2010 ATHERHOLT RD, LYNCHBURG, VA 24501
(434) 200-5047
(434) 200-6490
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101239992
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101239992
MEDICAL LICENSE NUMBER
VA
05
—
010294941
—
VA
Enumeration date
07/10/2006
Last updated
10/06/2015
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