Healthcare Provider Details

I. General information

NPI: 1063323533
Provider Name (Legal Business Name): FAITH CALVERT PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 S TRIMBLE RD
MANSFIELD OH
44906-3428
US

IV. Provider business mailing address

351 SABO DR
MANSFIELD OH
44905-2605
US

V. Phone/Fax

Practice location:
  • Phone: 419-521-6800
  • Fax:
Mailing address:
  • Phone: 901-827-8855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: