Provider Demographics
NPI:1205914249
Name:CALVERT, TERRI L (MD)
Entity type:Individual
Prefix:DR
First Name:TERRI
Middle Name:L
Last Name:CALVERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:320 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17554-1232
Mailing Address - Country:US
Mailing Address - Phone:717-285-7121
Mailing Address - Fax:717-285-5302
Practice Address - Street 1:1000 COMMERCE PARK DR
Practice Address - Street 2:SUITE 110
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-5475
Practice Address - Country:US
Practice Address - Phone:570-323-6944
Practice Address - Fax:570-323-4529
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPA045131L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001688660 0007Medicaid
PA006583LTDMedicare ID - Type Unspecified
PAG35771Medicare UPIN