Douglas, Michael Lee

Douglas, Michael Lee is an individual health care provider with primary practice located at 1110 Bergslien Street , Baldwin WI 54002. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Douglas, Michael Lee can be contacted via phone (715) 684-1111.

Contact Information

Primary practice address
1110 Bergslien Street Baldwin WI 54002
Phone: (715) 684-1111
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X 39759 Minnesota
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 56257-20 Wisconsin

Profile Details

NPI number 1902907454
LBN Legal business name Douglas, Michael Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2006
Last updated Dec 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902907454 NPPES
Minnesota Other 227GD3O BLUE CROSS/BLUE SHIELD

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