Provider Demographics
NPI:1841229267
Name:CALHOON, BRENT W (PA-C)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:W
Last Name:CALHOON
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1903 MORGANTOWN RD
Mailing Address - Street 2:INTEGRATED MEDICAL GROUP/GREENHILLS FAMILY PRACTICE
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19607-9620
Mailing Address - Country:US
Mailing Address - Phone:610-777-4040
Mailing Address - Fax:610-777-5575
Practice Address - Street 1:1903 MORGANTOWN RD
Practice Address - Street 2:INTEGRATED MEDICAL GROUP/GREENHILLS FAMILY PRACTICE
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19607-9620
Practice Address - Country:US
Practice Address - Phone:610-777-4040
Practice Address - Fax:610-777-5575
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2013-04-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA003345L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA097393Medicare ID - Type Unspecified
PAP30042Medicare UPIN