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General NPI Number Information
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NPI Number | 1669632071
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Entity Type | Organization
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Legal Business Name | CALVERT EAR NOSE & THROAT ASSOCIATES INC
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 110 HOSPITAL RD SUITE # 204
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-4019
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Country | US
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Telephone | 410-535-9555
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Fax |
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Provider Business Mailing Address
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Address Line | 110 HOSPITAL RD SUITE # 204
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-4019
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Country | US
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Telephone | 410-535-9555
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BETH R DUNCAN
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Credential | MD
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Telephone | 410-535-9555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D47767
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License Number State | MD
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