Individual
DOUGLAS MACCALLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2121 E WILLIAMS ST STE 108, APEX, NC 27539-7765
(919) 372-8412
Mailing address
113 SNOWY EGRET CT, DURHAM, NC 27704-5277
(562) 552-8959
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
P19411
NC
225100000X
Physical Therapist
Primary
P19411
NC
Other
Enumeration date
02/05/2020
Last updated
12/16/2022
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