Organization
MARY K O'CALLAGHAN DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY KEATING O'CALLAGHAN D.O. (PHYSICIAN)
(231) 845-7380
Entity
Organization
Contact information
Practice address
922 LAWNDALE ST, LUDINGTON, MI 49431-1928
(231) 845-7380
Mailing address
922 LAWNDALE ST, LUDINGTON, MI 49431-1928
(231) 845-7380
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
009391
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1155300045
BC GROUP
MI
05
—
2736118
—
MI
01
—
5530004
BCBS #
MI
01
—
DG2738
MEDICARE RR GROUP
MI
Enumeration date
07/10/2007
Last updated
03/07/2023
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