# CALVERTHEALTH MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CALVERT HEALTH SYSTEM, INC.
- **Other names:** CalvertHealth Medical Group
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1528880523
- **Legal business name:** CALVERT HEALTH SYSTEM, INC.
- **Authorized official:** CAROLYN HEITHAUS (CFO/VP FINANCE)
- **Authorized official phone:** (410) 535-8236

## Contact information

- **Practice address:** 130 HOSPITAL RD STE 102, PRINCE FREDERICK, MD 20678-4029
- **Practice address phone:** (410) 846-8800
- **Practice address fax:** (410) 469-1724
- **Mailing address:** 100 HOSPITAL RD, PRINCE FREDERICK, MD 20678-4017
- **Mailing address phone:** (410) 414-4791
- **Mailing address fax:** (410) 535-8417

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | — |
| 207RH0003X | Hematology & Oncology Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 208200000X | Plastic Surgery Physician | — | NULL | — |
| 208200000X | Plastic Surgery Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 2086S0105X | Surgery of the Hand (Surgery) Physician | — | NULL | — |
| 2086S0105X | Surgery of the Hand (Surgery) Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 10/30/2024
- **Last updated:** 10/30/2024