Smullen, Michael James
Smullen, Michael James is an sole proprietor health care provider with primary practice located at 1239 W Mason St , Green Bay WI 54303-2047. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatopathology is his primary health care specialty. Smullen, Michael James can be contacted 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:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | WI16879 | Wisconsin |
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ND0900X | WI16879 | Wisconsin |
Profile Details
| NPI number | 1023020120 |
|---|---|
| LBN Legal business name | Smullen, Michael James |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 13th, 2006 |
| Last updated | Sep 22nd, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023020120 | NPPES |
| Wisconsin | MEDICAID | 30979400 |
Popular Providers
-
Ecker, Richard I
706 Ne Evans St , Mcminnville OR 97128-3926 -
Brownstein, Martin H
2 N Plandome Rd , Port Washington NY 11050-3443 -
De Castro, Fernando R.
250 Fountain Ct , Lexington KY 40509-1888 -
Kasch, John A
2721 Capitol Ave , Sacramento CA 95816-6004 -
Hodge, Steven J
310 E Broadway Ste 200, Louisville KY 40202-1745 -
Clemons, Donald Eugene
1009 North State Of Franklin Access Road , Johnson City TN 37604-3693 -
Stone, Richard L
1275 N University Ave Ste 23 , Provo UT 84604-7125 -
Huether, Michael J.
5980 N La Cholla Blvd , Tucson AZ 85741-3535