Individual
DR. CHERYL M CALLAGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
500 S 11TH AVE, SUITE 201, POCATELLO, ID 83201-4835
(208) 233-8000
(208) 233-2220
Mailing address
500 S 11TH AVE, SUITE 201, POCATELLO, ID 83201-4835
(208) 233-8000
(208) 233-2220
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
M7272
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010003881
REGENCE BLUE SHIELD
ID
01
—
160043917
RAILROAD MEDICARE
ID
01
—
76955
BLUE CROSS
ID
05
—
805068600
—
ID
Enumeration date
05/23/2006
Last updated
05/12/2016
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