CORY CALLAHAN (NPI# 1932647112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932647112 |
| Entity Type | Individual |
| Full Name | CORY CALLAHAN |
| Credential | PA-C |
| Practice Address |
417 State St, Suite 340 Bangor ME 04401 |
| Mailing Address |
43 Whiting Hill Rd Suite 300 Brewer ME 04412 |
| Practice Telephone | 2079734949 |
| Practice Fax Number | 2079734466 |
| Mailing Telephone | 2079734949 |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2017-12-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA1675 | ME | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
417 STATE ST, SUITE 340 |
| City | BANGOR |
| State | ME |
| Zip Code | 04401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1437559010 | Shelby June Slauenwhite | Physician Assistant | 489 State St Ste 221, Bangor, ME 04401-6616 | 2014-09-02 |
| 1437242294 | Sunbury Primary Care, P.a. | Physician Assistant | 133 Corporate Drive, Suite 5, Bangor, ME 04401 | 2006-10-02 |
| 1891890166 | John F Cassidy Iv | Physician Assistant | 34 Summer St, Bangor, ME 04401-6446 | 2006-09-13 |
| 1831124338 | Isolde Kissinger | Physician Assistant | 520 Railroad St, Bangor, MI 49013-1490 | 2006-07-12 |
| 1366472847 | Michael Moreau | Physician Assistant | 417 State Street Webber West Suite 340, Bangor, ME 04401-6616 | 2006-07-03 |
| 1104868603 | Karen D Godin | Physician Assistant | 417 State St Ste 400, Penobscot Respiratory, Bangor, ME 04401-6096 | 2006-06-11 |
| 1912976911 | Joseph Harkins | Physician Assistant | 417 State St Ste 121, Bangor, ME 04401-6630 | 2006-03-14 |
| 1932194214 | Shirley E Sanders | Physician Assistant | 555 Railroad St, Bangor, MI 49013-1464 | 2005-09-13 |
| 1588277958 | Shannon Lee Niedbala | Physician Assistant | 543 Broadway, Bangor, ME 04401-3337 | 2020-08-26 |
| Find all providers in BANGOR | ||||
Please comment or provide details below to improve the information on CORY CALLAHAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.