Healthcare Provider Details

I. General information

NPI: 1417535287
Provider Name (Legal Business Name): JOSHUA DAVID CALVANO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48TH MDG RAF LAKENHEATH
APO AE
09461
US

IV. Provider business mailing address

UNIT 5210 BOX 230
APO AE
09461
US

V. Phone/Fax

Practice location:
  • Phone: 314-226-8284
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0102208673
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number0102208673
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: