Provider Demographics
NPI:1174857429
Name:CALDERON, ENRIQUE EDUARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:ENRIQUE
Middle Name:EDUARDO
Last Name:CALDERON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4101 CAMPUS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5077
Mailing Address - Country:US
Mailing Address - Phone:704-234-1930
Mailing Address - Fax:704-234-1940
Practice Address - Street 1:4101 CAMPUS RIDGE RD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5077
Practice Address - Country:US
Practice Address - Phone:704-234-1930
Practice Address - Fax:704-234-1940
Is Sole Proprietor?:No
Enumeration Date:2009-09-18
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-02306207W00000X
TXP2205207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist