Individual
DR. JOHN P MACCALLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
618 N HOWE ST, SOUTHPORT, NC 28461-3426
(910) 454-0404
Mailing address
404 TATE LAKE DR, SOUTHPORT, NC 28461-9746
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
10552
WV
2084P0800X
Psychiatry Physician
Primary
2015-02275
NC
Other
Enumeration date
11/15/2005
Last updated
04/04/2019
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