Provider Demographics
NPI:1497742142
Name:CALVINO, HARRY S (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:S
Last Name:CALVINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 COBBLESTONE CT
Mailing Address - Street 2:
Mailing Address - City:FT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2832
Mailing Address - Country:US
Mailing Address - Phone:970-226-1210
Mailing Address - Fax:
Practice Address - Street 1:1100 COBBLESTONE CT
Practice Address - Street 2:
Practice Address - City:FT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2832
Practice Address - Country:US
Practice Address - Phone:970-226-1210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2016-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13442207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC806074Medicare PIN
AZE47675Medicare UPIN
COC809408Medicare PIN