Provider Demographics
NPI:1811796188
Name:CALMESE, FREDERICK D
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:D
Last Name:CALMESE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1931 MARHOFER AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-4034
Mailing Address - Country:US
Mailing Address - Phone:330-475-4195
Mailing Address - Fax:
Practice Address - Street 1:645 HOWE AVE # 1110
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-4955
Practice Address - Country:US
Practice Address - Phone:330-474-9041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRT453764172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty