Provider Demographics
NPI:1821310004
Name:CALDERON, AMY S (DO, PHARMD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:S
Last Name:CALDERON
Suffix:
Gender:F
Credentials:DO, PHARMD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:MICHEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO, PHARMD
Mailing Address - Street 1:100 DEBARTOLO PL STE 200
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6095
Mailing Address - Country:US
Mailing Address - Phone:330-729-8146
Mailing Address - Fax:330-965-5229
Practice Address - Street 1:8740 E MARKET ST STE 2
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2324
Practice Address - Country:US
Practice Address - Phone:234-287-6590
Practice Address - Fax:330-965-5090
Is Sole Proprietor?:No
Enumeration Date:2010-02-16
Last Update Date:2025-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.012732207RG0100X
NY048857183500000X
NY271550207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No183500000XPharmacy Service ProvidersPharmacist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0220079Medicaid