Provider Demographics
NPI:1386921864
Name:CALAME, COLETTE SUZANNE (CCP LP)
Entity type:Individual
Prefix:
First Name:COLETTE
Middle Name:SUZANNE
Last Name:CALAME
Suffix:
Gender:F
Credentials:CCP LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6124 PANDA WAY
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73165-8410
Mailing Address - Country:US
Mailing Address - Phone:405-620-2412
Mailing Address - Fax:405-271-6135
Practice Address - Street 1:6124 PANDA WAY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73165-8410
Practice Address - Country:US
Practice Address - Phone:405-620-2412
Practice Address - Fax:405-271-6135
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6242T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist