Provider Demographics
NPI:1487616090
Name:DOBSON-CALLAHAN, KIM MELISSA (MD)
Entity type:Individual
Prefix:MRS
First Name:KIM
Middle Name:MELISSA
Last Name:DOBSON-CALLAHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:MELISSA
Other - Last Name:DOBSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:445 WINN WAY FL 2
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1707
Mailing Address - Country:US
Mailing Address - Phone:404-294-3745
Mailing Address - Fax:
Practice Address - Street 1:445 WINN WAY FL 2
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030
Practice Address - Country:US
Practice Address - Phone:404-294-3745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1954442084P0800X
GA0726182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01498493Medicaid
NY01498493Medicaid
NYRA6441Medicare PIN