Provider Demographics
NPI:1144290115
Name:CALDERONE, DAVID (DPM)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:CALDERONE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 N POINTE BLVD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4132
Mailing Address - Country:US
Mailing Address - Phone:717-299-4871
Mailing Address - Fax:717-391-2494
Practice Address - Street 1:170 N POINTE BLVD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4132
Practice Address - Country:US
Practice Address - Phone:717-299-4871
Practice Address - Fax:717-391-2494
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001665213ES0103X
PASC003735R213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4855050000OtherBCBS
MI3182954Medicaid
MI1144290115OtherRAILROAD MEDICARE
MI0E07641Medicare ID - Type Unspecified
MI3182954Medicaid