Individual
ADAM PETER CALUSIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
215 WASHINGTON ST, GRAFTON, WI 53024
(262) 375-3700
(262) 375-6306
Mailing address
215 WASHINGTON ST, GRAFTON, WI 53024-1700
(262) 375-3700
(262) 375-6306
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
66284
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000161435
HIGHMARK BLUE SHIELD
PA
05
—
0006805790004
—
PA
01
—
0038505000
BLUE SHIELD
—
05
—
100061643
—
WI
01
—
4663112
AETNA
PA
01
—
50051256
BLUE CROSS
—
01
—
O002395
GATEWAY
—
01
—
P00258005
RR MEDICARE
—
Enumeration date
06/29/2006
Last updated
11/29/2021
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