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Organization
CALVERTHEALTH MEDICAL GROUP, LLC
Active
Organization
CALVERTHEALTH MEDICAL GROUP, LLC
Active
Other names
CalvertHealth Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN HEITHAUS (CFO)
(410) 535-8236
Entity
Organization
Contact information
Practice address
110 HOSPITAL RD STE 110, PRINCE FREDERICK, MD 20678-4039
(410) 535-4488
(443) 771-8114
Mailing address
100 HOSPITAL RD, PRINCE FREDERICK, MD 20678-4017
(410) 414-4791
(410) 535-8417
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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