Provider Demographics
NPI:1235230947
Name:CALHOUN, MICHAEL STANTON (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:STANTON
Last Name:CALHOUN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 HOLT RD
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-5021
Mailing Address - Country:US
Mailing Address - Phone:978-270-7494
Mailing Address - Fax:
Practice Address - Street 1:451 ANDOVER STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5021
Practice Address - Country:US
Practice Address - Phone:978-681-4500
Practice Address - Fax:866-768-6532
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3062111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1600460Medicaid
U02919Medicare UPIN
MA1600460Medicaid