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General NPI Number Information
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NPI Number | 1396534418
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Entity Type | Organization
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Legal Business Name | CALVERTHEALTH MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 14090 HG TRUEMAN RD STE 1100
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City | SOLOMONS
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State | MD
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Zip | 20688-3151
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Country | US
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Telephone | 410-414-4740
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Fax | 410-414-4741
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Provider Business Mailing Address
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Address Line | 100 HOSPITAL RD
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-4017
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Country | US
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Telephone | 410-535-8248
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Fax | 410-535-8417
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Authorized Official
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Title or Position | CFO/VP OF FINANCE
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Name | CAROLYN HEITHAUS
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Credential |
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Telephone | 410-535-8236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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