Provider Demographics
NPI:1699767764
Name:DYER, CALVIN ROBINSON (MD)
Entity type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:ROBINSON
Last Name:DYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:C.
Other - Middle Name:ROBINSON
Other - Last Name:DYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 306556
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6556
Mailing Address - Country:US
Mailing Address - Phone:615-329-2294
Mailing Address - Fax:615-695-1494
Practice Address - Street 1:3443 DICKERSON PIKE
Practice Address - Street 2:SUITE 480
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2519
Practice Address - Country:US
Practice Address - Phone:615-263-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD24487207XX0005X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ018002Medicaid
TNF64801Medicare UPIN