Michael J. Smullen, Md

LBN: Michael J. Smullen, Md
Michael J. Smullen, Md is an health care organization with primary practice located at 1239 W Mason St , Green Bay WI 54303-2047. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Michael J. Smullen, Md can be contacted via phone (920) 499-0696, or through Smullen, Michael J. via phone (920) 499-0696.

Contact Information

Primary practice address
1239 W Mason St Green Bay WI 54303-2047
Phone: (920) 499-0696
Fax: (920) 499-0697
Website:
Map and Directions
Authorized official contact:
Name: Smullen, Michael J. Doctor of Medicine (MD)
Phone: (920) 499-0696

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X

Profile Details

NPI number 1194148379
LBN Legal business name Michael J. Smullen, Md
DBA Doing business as
Authorized official Smullen, Michael J. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 24th, 2014
Last updated Jan 24th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194148379 NPPES
Wisconsin MEDICAID 30979400

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