Individual
DR. MICHAEL DOUGLAS CALLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2070 BIDDLE AVE, SUITE 200, WYANDOTTE, MI 48192-4080
(734) 225-9100
(734) 225-9176
Mailing address
1640 FORT STREET, SUITE D ATTN DENISE, TRENTON, MI 48183
(734) 391-3057
(734) 391-3052
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
5101016780
MI
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
5101016780
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H28427
BLUE CROSS
MI
01
—
1699102244
GROUP NPI HENRY FORD WYANDOTTE
MI
Enumeration date
05/22/2007
Last updated
02/21/2017
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