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Organization
CALVERTHEALTH MEDICAL GROUP, LLC
Active
Organization
CALVERTHEALTH MEDICAL GROUP, LLC
Active
Parent organization
CALVERT HEALTH SYSTEM, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
CALVERT HEALTH SYSTEM, INC.
Authorized official
CAROLYN HEITHAUS (CFO)
(410) 535-8236
Entity
Organization
Contact information
Practice address
110 HOSPITAL RD STE 204, PRINCE FREDERICK, MD 20678-4045
(410) 414-4740
(410) 414-4741
Mailing address
100 HOSPITAL RD, PRINCE FREDERICK, MD 20678-4017
(410) 414-4791
(410) 535-8417
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
—
NULL
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Enumeration date
07/10/2024
Last updated
07/10/2024
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