Provider Demographics
NPI:1225813405
Name:ATIENZA CALINGACION, PHOEBE BERBER
Entity Type:Individual
Prefix:
First Name:PHOEBE
Middle Name:BERBER
Last Name:ATIENZA CALINGACION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6966 HANOVER PKWY APT 301
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2229
Mailing Address - Country:US
Mailing Address - Phone:301-906-0701
Mailing Address - Fax:
Practice Address - Street 1:6966 HANOVER PKWY APT 301
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2229
Practice Address - Country:US
Practice Address - Phone:301-906-0701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR176785207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDW23121257MOtherDEA