# CALVERTHEALTH MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CALVERT HEALTH SYSTEM, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1558108472
- **Legal business name:** CALVERT HEALTH SYSTEM, INC.
- **Authorized official:** CAROLYN HEITHAUS (CFO)
- **Authorized official phone:** (410) 535-8236

## Contact information

- **Practice address:** 110 HOSPITAL RD STE 101, PRINCE FREDERICK, MD 20678-4019
- **Practice address phone:** (410) 535-8195
- **Practice address fax:** (410) 280-7323
- **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 | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RB0002X | Obesity Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RB0002X | Obesity Medicine (Internal Medicine) Physician | — | — | — |
| 207RG0100X | Gastroenterology Physician | — | NULL | — |
| 207RG0100X | Gastroenterology Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/09/2024
- **Last updated:** 07/10/2024