Provider Demographics
NPI:1932197514
Name:CALHOUN, CAROL E (RPA-C)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:E
Last Name:CALHOUN
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1185 SWEET HOME RD
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1018
Mailing Address - Country:US
Mailing Address - Phone:716-689-0040
Mailing Address - Fax:716-422-2802
Practice Address - Street 1:1185 SWEET HOME RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1018
Practice Address - Country:US
Practice Address - Phone:716-668-9004
Practice Address - Fax:716-422-2802
Is Sole Proprietor?:No
Enumeration Date:2005-10-08
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0094001363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000570456001OtherBLUE CROSS/BLUE SHIELD
NY00026590301OtherUNIVERA
NY9512039OtherINDPENDENT HEALTH
NY0046122OtherGHI
NY01266531Medicaid
NY000570456001OtherBLUE CROSS/BLUE SHIELD
NY0046122OtherGHI