Provider Demographics
NPI:1245936137
Name:CALVIN, ASHLEY MEGAN
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:MEGAN
Last Name:CALVIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 N HAGGERTY RD APT 204
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1685
Mailing Address - Country:US
Mailing Address - Phone:248-943-6627
Mailing Address - Fax:
Practice Address - Street 1:350 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10118-0110
Practice Address - Country:US
Practice Address - Phone:212-868-5790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302414808183500000X
NY070095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist