Provider Demographics
NPI:1023332541
Name:CALLAHAN, JOSEPH BRODHEAD (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:BRODHEAD
Last Name:CALLAHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 BURNING TREE DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27537-9608
Mailing Address - Country:US
Mailing Address - Phone:252-492-7459
Mailing Address - Fax:
Practice Address - Street 1:391 BURNING TREE DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27537-9608
Practice Address - Country:US
Practice Address - Phone:252-492-7459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-26
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20531207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology