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Individual

DR. JOHN ANTHONY CALCAGNO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
24850 SE STARK ST, STE 150, GRESHAM, OR 97030-8318
(503) 491-0714
(503) 674-2834
Mailing address
24850 SE STARK ST, STE 150, GRESHAM, OR 97030-8318
(503) 491-0714
(503) 674-2834

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD14823
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
153684
OR
Enumeration date
10/26/2005
Last updated
10/14/2011
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