Herminio C Calderon, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

038943 Issued in MI

Practice address

1530 Pine Grove Ave
Suite 7
Port Huron, MI 48060

Phone

(810) 985-0029

Fax

(810) 985-0032

NPI assigned

Aug 12, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578575320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 PINE GROVE AVE",
            "address_2": "SUITE 7",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "48060",
            "telephone_number": "810-985-0029",
            "fax_number": "810-985-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 PINE GROVE AVE",
            "address_2": "SUITE 7",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "48060",
            "telephone_number": "810-985-0029",
            "fax_number": "810-985-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "HERMINIO",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "038943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1422111",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.