Basic Information
| Provider Information | |||||||||
| NPI: | 1114907615 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CALVERT FAMILY PRACTICE ASSOCIATES, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 HOSPITAL RD | ||||||||
| Address2: | SUITE 111 | ||||||||
| City: | PRINCE FREDERICK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206784019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105354488 | ||||||||
| FaxNumber: | 4105356131 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 HOSPITAL RD | ||||||||
| Address2: | SUITE 111 | ||||||||
| City: | PRINCE FREDERICK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206784019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105354488 | ||||||||
| FaxNumber: | 4105356131 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SCHLAGER | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | JOHN | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4105354488 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.