Organization
P. DOUGLAS CALLAN & ASSOC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL DOUGLAS CALLAN PHD (PSYCHOLOGIST)
(810) 629-6549
Entity
Organization
Contact information
Practice address
1361 N LONG LAKE RD, FENTON, MI 48430-8867
(810) 629-6549
(810) 629-0614
Mailing address
1361 N LONG LAKE RD, FENTON, MI 48430-8867
(810) 629-6549
(810) 629-0614
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301002282
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117163
VALUE OPTIONS
MI
01
—
2050633
CIGNA
MI
01
—
248189
MHN
MI
01
—
266552
HORIZON
MI
01
—
38741455
TRICARE
MI
01
—
680B54550-0
BLUE CROSS
MI
01
—
8915160
CIGNA
MI
01
—
IP285944
MAGELLAN
MI
01
—
M036569
CHAMPUS
MI
01
—
P99889
BLUE CARE NETWORK
MI
Enumeration date
05/11/2007
Last updated
03/14/2013
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