Individual
AVERY CALLAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
5180
SC
Other
Enumeration date
05/04/2023
Last updated
04/20/2026
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