Provider Demographics
NPI:1700923596
Name:CALVELLO HYNES, EMILIE J (MD)
Entity type:Individual
Prefix:DR
First Name:EMILIE
Middle Name:J
Last Name:CALVELLO HYNES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EMILIE
Other - Middle Name:JB
Other - Last Name:CALVELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:PO BOX 749112
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-9112
Mailing Address - Country:US
Mailing Address - Phone:434-295-1000
Mailing Address - Fax:
Practice Address - Street 1:1215 LEE ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0816
Practice Address - Country:US
Practice Address - Phone:434-924-2231
Practice Address - Fax:434-924-2231
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101282912207P00000X
NE27837207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD417904800Medicaid
MD417904800Medicaid