Individual
DR. TODD RICHARD CALLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 SOUTH MADISON ST, WAUPUN, WI 53963
(920) 324-6235
Mailing address
200 SOUTH MADISON ST, PO BOX 351, WAUPUN, WI 53963
(920) 324-6235
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
43091-020
WI
Other
Enumeration date
03/30/2007
Last updated
07/08/2007
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