Provider Demographics
NPI:1427280049
Name:CALLENBERGER, RONALD WAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:WAYNE
Last Name:CALLENBERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:586 FISCHLER STREET EXT
Mailing Address - Street 2:
Mailing Address - City:WELLSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16901-7862
Mailing Address - Country:US
Mailing Address - Phone:570-724-1209
Mailing Address - Fax:570-724-6636
Practice Address - Street 1:586 FISCHLER STREET EXT
Practice Address - Street 2:
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901-7862
Practice Address - Country:US
Practice Address - Phone:570-724-1209
Practice Address - Fax:570-724-6636
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-15
Last Update Date:2009-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD011766-E(PA)207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery