Provider Demographics
NPI:1558548826
Name:VERMEIRE, CALVIN (DO)
Entity Type:Individual
Prefix:
First Name:CALVIN
Middle Name:
Last Name:VERMEIRE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:LAPORTE
Mailing Address - State:PA
Mailing Address - Zip Code:18626-0246
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:YUKON KUSKOKWIM HEALTH CORPORTATION
Practice Address - Street 2:CHIEF EDDY HOFFMAN HIGHWAY
Practice Address - City:BETHEL
Practice Address - State:AK
Practice Address - Zip Code:99559
Practice Address - Country:US
Practice Address - Phone:907-543-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS 006701E207Q00000X
AKAA1562207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine