Provider Demographics
NPI:1003025362
Name:CALKIN, PETER JOSEPH (DO)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:JOSEPH
Last Name:CALKIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:907 SUMNER ST
Mailing Address - Street 2:SUITE M201
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-3374
Mailing Address - Country:US
Mailing Address - Phone:781-344-2325
Mailing Address - Fax:781-341-8544
Practice Address - Street 1:907 SUMNER ST
Practice Address - Street 2:SUITE M201
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-3374
Practice Address - Country:US
Practice Address - Phone:781-344-2325
Practice Address - Fax:781-341-8544
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA204105207L00000X
MA228536207L00000X
MI5101019121207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0550900704OtherBCBS
MI1003025362Medicaid
MIP00936959OtherRAILROAD MEDICARE
MI1003025362Medicaid