Michael Craig Callis, D.C.
Individual provider Active NPI Chiropractor · Meridian, ID
NPI 1285857797 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1285857797
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- CHIA-952 (ID)
- Practice address
- 2053 E Fairview Ave
Suite #107
Meridian, ID 83642-8043 - Phone
- (208) 353-1743
- Fax
- (208) 895-0978
- NPI assigned
- Apr 11, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIA-952 | ID | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIA-952 | ID | Yes |
Addresses
Primary practice location
2053 E Fairview Ave
Suite #107
Meridian, ID 83642-8043
Mailing address
2235 W Tumble Creek Dr
Meridian, ID 83642-8241
Phone (208) 353-1743
Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.