Provider Demographics
NPI:1154474807
Name:CALVERT, PRESTON C (MD)
Entity Type:Individual
Prefix:
First Name:PRESTON
Middle Name:C
Last Name:CALVERT
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5249 DUKE ST STE 401
Mailing Address - Street 2:SUITE 401
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-2907
Mailing Address - Country:US
Mailing Address - Phone:703-461-1908
Mailing Address - Fax:703-461-1925
Practice Address - Street 1:5249 DUKE ST STE 401
Practice Address - Street 2:SUITE 401
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-2907
Practice Address - Country:US
Practice Address - Phone:703-461-1908
Practice Address - Fax:703-461-1925
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA449742084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF05673Medicare UPIN