Individual
PATRICIA CALLAWAY DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
307 BOATNER RD, EGLIN AFB, FL 32542-1302
(904) 476-0775
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME98938
FL
2084P0800X
Psychiatry Physician
ME98938
FL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME98938
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198001904A
—
GA
05
—
2787253 00
—
FL
05
—
278725300
—
FL
Enumeration date
09/22/2006
Last updated
05/08/2018
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