Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 14244 | SC |
NPI | 1821168899 |
---|---|
Provider Name | Dr. Joseph J Calandra II |
First Address | Mt Pleasant, SC 29466-8048 |
Second Address | Mt Pleasant, SC 29466-8048 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 08/07/2007 |