Healthcare Provider Details

I. General information

NPI: 1821060625
Provider Name (Legal Business Name): BYRON C CALHOUN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 04/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 PENNSYLVANIA AVE
CHARLESTON WV
25302-3302
US

IV. Provider business mailing address

830 PENNSYLVANIA AVE
CHARLESTON WV
25302-3302
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-1599
  • Fax:
Mailing address:
  • Phone: 304-388-1599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number24315
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number22187
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: