Provider Demographics
NPI:1801849757
Name:CALAGNA, MARIA ANNA (PAC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ANNA
Last Name:CALAGNA
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51055 ACE DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48042-4322
Mailing Address - Country:US
Mailing Address - Phone:313-382-3841
Mailing Address - Fax:810-765-8169
Practice Address - Street 1:6071 W OUTER DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-2624
Practice Address - Country:US
Practice Address - Phone:313-966-3300
Practice Address - Fax:810-765-8169
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X, 363AM0700X, 363AS0400X
MI5601004230363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical