Healthcare Provider Details

I. General information

NPI: 1720668700
Provider Name (Legal Business Name): JOHN ELLIOTT CALVERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 PLANTATION PARK DR STE 202
BLUFFTON SC
29910-9008
US

IV. Provider business mailing address

29 PLANTATION PARK DR STE 202
BLUFFTON SC
29910-9008
US

V. Phone/Fax

Practice location:
  • Phone: 843-836-2200
  • Fax: 843-757-2202
Mailing address:
  • Phone: 843-836-2200
  • Fax: 843-757-2202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number86256
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: