Provider Demographics
NPI:1376907071
Name:CALDERONE, MICHAEL ERNESTO (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ERNESTO
Last Name:CALDERONE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1600 HIGH ST N STE 201
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-1922
Mailing Address - Country:US
Mailing Address - Phone:856-825-9009
Mailing Address - Fax:404-446-1957
Practice Address - Street 1:1600 HIGH ST N STE 201
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-1922
Practice Address - Country:US
Practice Address - Phone:856-825-9009
Practice Address - Fax:404-446-1957
Is Sole Proprietor?:No
Enumeration Date:2016-04-08
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00345000213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery