Provider Demographics
NPI:1629017470
Name:CALABRETTA, ARTHUR M (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:M
Last Name:CALABRETTA
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 1:1918 RANDOLPH RD
Mailing Address - Street 2:STE 850
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207
Mailing Address - Country:US
Mailing Address - Phone:704-444-5800
Mailing Address - Fax:704-444-5819
Practice Address - Street 1:1918 RANDOLPH RD
Practice Address - Street 2:STE 850 CALABRETTA COSMETIC SURGERY CENTER PLLC
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207
Practice Address - Country:US
Practice Address - Phone:704-444-5800
Practice Address - Fax:704-444-5819
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC256962086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891187AMedicaid
NC891187AMedicaid
C86384Medicare UPIN