Basic Information
| Provider Information | |||||||||
| NPI: | 1306809710 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CALVERT | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | JOHN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12236 GALESVILLE DR | ||||||||
| Address2: | |||||||||
| City: | GAITHERSBURG | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208782072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018461246 | ||||||||
| FaxNumber: | 3108465946 | ||||||||
| Practice Location | |||||||||
| Address1: | 8901 WISCONSIN AVE | ||||||||
| Address2: | |||||||||
| City: | BETHESDA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208890001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012950196 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 0101037536 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.