Individual
DR. PETER MICHAEL WILUSZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
5730 BELLA ROSA BLVD STE 200, CLARKSTON, MI 48348
(248) 922-6000
(248) 922-5997
Mailing address
5730 BELLA ROSA BLVD STE 200, CLARKSTON, MI 48348-4774
(248) 922-6000
(248) 922-5997
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PW002033
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4856315560
BLUE CROSS
MI
01
—
4858214660
BLUE CROSS BLUSE SHIELD
MI
05
—
4940030 TYPE 13
—
MI
Enumeration date
12/31/2005
Last updated
06/11/2018
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