Healthcare Provider Details

I. General information

NPI: 1225578131
Provider Name (Legal Business Name): AMITY CALVIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2017
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 CENTRO FAMILIAR BLVD SW STE A
ALBUQUERQUE NM
87105-4592
US

IV. Provider business mailing address

2001 CENTRO FAMILIAR BLVD SW STE A
ALBUQUERQUE NM
87105-4592
US

V. Phone/Fax

Practice location:
  • Phone: 505-873-7400
  • Fax:
Mailing address:
  • Phone: 505-873-7400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD2023-1360
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: