Provider Demographics
NPI:1588718605
Name:CALLAHAN, CLARA A (MD)
Entity type:Individual
Prefix:DR
First Name:CLARA
Middle Name:A
Last Name:CALLAHAN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:NEMOURS CHILDRENS CLINIC
Mailing Address - Street 2:P.O. BOX 404112
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-0001
Mailing Address - Country:US
Mailing Address - Phone:904-390-3610
Mailing Address - Fax:904-288-5890
Practice Address - Street 1:JEF FACULTY PEDS AND DUPONT CHILDRENS HLTH PROG
Practice Address - Street 2:833 CHESTNUT STREET EAST SUITE 300
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4413
Practice Address - Country:US
Practice Address - Phone:215-955-7800
Practice Address - Fax:215-923-9383
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2008-05-02
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Provider Licenses
StateLicense IDTaxonomies
PAMD021793E208000000X, 208D00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000860227Medicaid
NJ3774440Medicaid
MD4098072Medicaid
C29189Medicare UPIN