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NPI Code Detail

MEDICARE: DR. COLENE MARIE CALO DO

MEDICARE: DR. COLENE MARIE CALO DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology PhysicianOS13448FL
2207NS0135XProcedural Dermatology Physician5101012868MI
3207N00000XDermatology Physician2018-02899NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15500270OTHERMIBLUE CROSS BLUE SHIELD MI

General Provider Information

NPI Number : 1396790317
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. COLENE MARIE CALO DO
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number : 704-316-5070
Fax Number : 704-316-5075
Provider Business Practice Location Address
First Line : 9604 HOLLY POINT DR
Second Line :
City : HUNTERSVILLE
State : NC
Zip : 28078-4913
Country : US
Telephone Number : 704-316-5070
Fax Number : 704-316-5075
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 12/04/2018

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Directions to “ DR. COLENE MARIE CALO DO” Practice Location

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