Provider Demographics
NPI:1467408658
Name:WILLIAMS, CALVIN B (MD)
Entity Type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:B
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:PEDIATRIC RHEUMATOLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-6700
Mailing Address - Fax:414-266-6695
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:PEDIATRIC RHEUMATOLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-266-6700
Practice Address - Fax:414-266-6695
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI445302080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
005000261MOtherHUMANA
WI1467408658Medicaid
G24801Medicare UPIN
0012573601Medicare ID - Type Unspecified