Provider Demographics
NPI:1457376931
Name:CALCAGNO, MARCO T (CPO)
Entity Type:Individual
Prefix:MR
First Name:MARCO
Middle Name:T
Last Name:CALCAGNO
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9120 DEERSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-4099
Mailing Address - Country:US
Mailing Address - Phone:919-441-0023
Mailing Address - Fax:919-594-1175
Practice Address - Street 1:9120 DEERSHIRE CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4099
Practice Address - Country:US
Practice Address - Phone:919-441-0023
Practice Address - Fax:919-594-1175
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist