Provider Demographics
NPI:1225244064
Name:DANIEL CALHOUN JR MD LLC
Entity Type:Organization
Organization Name:DANIEL CALHOUN JR MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-898-3725
Mailing Address - Street 1:114 WYNNE RD
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:VA
Mailing Address - Zip Code:23692-2944
Mailing Address - Country:US
Mailing Address - Phone:757-898-3725
Mailing Address - Fax:
Practice Address - Street 1:12720 MCMANUS BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-4414
Practice Address - Country:US
Practice Address - Phone:757-875-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101029941208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC08376Medicare PIN