Provider Demographics
NPI:1972737179
Name:SHAWN DHILLON, M.D., P.C.
Entity Type:Organization
Organization Name:SHAWN DHILLON, M.D., P.C.
Other - Org Name:CALVERT CHIROPRACTIC & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:DHILLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-261-8800
Mailing Address - Street 1:3333 N CALVERT ST. CALVERT MEDICAL GROUP
Mailing Address - Street 2:STE. 555 CALVERT MEDICAL GROUP
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-2867
Mailing Address - Country:US
Mailing Address - Phone:410-261-8800
Mailing Address - Fax:410-261-8813
Practice Address - Street 1:3333 N CALVERT ST
Practice Address - Street 2:STE. 585
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2867
Practice Address - Country:US
Practice Address - Phone:410-261-8009
Practice Address - Fax:410-261-8055
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHAWN DHILLON, M.D., P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-04
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSO1595111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD211PMedicare PIN