Healthcare Provider Details

I. General information

NPI: 1033349808
Provider Name (Legal Business Name): EMMA ELIZABETH CALVERT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROOM H-804, SA-1 2401 E STREET, N.W.
WASHINGTON DC
20522-0108
US

IV. Provider business mailing address

UNIT 6050 BOX 23
DPO AE
09892-0023
US

V. Phone/Fax

Practice location:
  • Phone: 757-984-7155
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA60372079
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA20413
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number023414-1
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110006617
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: