Healthcare Provider Details

I. General information

NPI: 1356361869
Provider Name (Legal Business Name): ALICE OH CALHOUN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DR HITZELBERGER STRASSE
LANDSTUHL RHINELAND-PALATINATE
66849
DE

IV. Provider business mailing address

UNIT 33100
APO AE
09180-3100
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-7056
  • Fax:
Mailing address:
  • Phone: 314-590-7056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101058322
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: