Basic Information
| Provider Information | |||||||||
| NPI: | 1023139706 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CALHOUN | ||||||||
| FirstName: | ALICE | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 RANDOLPH ST | ||||||||
| Address2: | |||||||||
| City: | DENTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216291243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104794306 | ||||||||
| FaxNumber: | 4104791714 | ||||||||
| Practice Location | |||||||||
| Address1: | 933 S TALBOT STREET | ||||||||
| Address2: | UNIT 4 | ||||||||
| City: | ST MICHAELS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216632633 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107450200 | ||||||||
| FaxNumber: | 4107450492 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2007 | ||||||||
| LastUpdateDate: | 09/04/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | E2366 | AR | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | D0066684 | MD | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 521116591 | 01 | MD | INFORMED | OTHER | 521116591 | 01 | COVENTRY | OTHER | 8173947 | 01 | MD | OPTIMUM CHOICEMDIPAMAMSI | OTHER | 892320 | 01 | MD | NCPPO | OTHER | P17770 | 01 | MD | CAREFIRST BC/BS POS | OTHER | 2173947 | 01 | MD | MAMSI/ALLIANCE | OTHER | 521116591 | 01 | MD | TRICARE | OTHER | 7417121 | 01 | AETNA | OTHER | 91412301 | 01 | MD | CAREFIRST BC/BS RENDERING | OTHER | 212339 | 01 | MD | PRIORITY PARTNERS | OTHER | 784381000 | 05 | MD | MEDICAID | T5880042 | 01 | MD | CF BC/BS GRP/GHMSI/BL CHO | OTHER | 521116591 | 01 | MD | MARYLAND PHYSICIAN CARE | OTHER | 6332791 | 01 | MD | CIGNA | OTHER |