Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | OS015013 | PA |
N | 111NI0900X | Internist | OS015013 | PA |
Y | 207RG0100X | Gastroenterologist | DR.0062270 | CO |
N | 207RG0100X | Gastroenterologist | OS015013 | PA |
N | 208D00000X | General Practice Physician | OS015013 | PA |
NPI | 1013178508 |
---|---|
Provider Name | Dr. Christopher John Calcagno |
First Address | Denver, CO 80256-0825 |
Second Address | Pueblo, CO 81003-2742 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2008 |
Last Update Date | 05/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9000173652 | (05) | CO |