MEDICARE: BRIAN LEWIS CALHOUN MD

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
1	207L00000X	Anesthesiology Physician	34111	NH
2	207L00000X	Anesthesiology Physician	042-007957	VT
3	207L00000X	Anesthesiology Physician	042-0007957	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	00008400	OTHER	VT	BLUE CROSS

General Provider Information

NPI Number	:	1649292814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN LEWIS CALHOUN MD

Provider Business Mailing Address
First Line	:	129 BROWNS TRACE RD
Second Line	:
City	:	JERICHO
State	:	VT
Zip	:	05465-2034
Country	:	US
Telephone Number	:	802-363-3602
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 PORTER DR
Second Line	:
City	:	MIDDLEBURY
State	:	VT
Zip	:	05753-8423
Country	:	US
Telephone Number	:	802-388-4701
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	01/17/2025

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