Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MICHAEL JAMES SMULLEN, MD
Active Sole ProprietorDermatopathology · GREEN BAY, WI
Registration Details
- NPI Number
- 1023020120
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 13, 2006 (19.689785257839 yrs)
- Last Updated
- Sep 22, 2010
- Licenses
-
WI16879 (WI)WI16879 (WI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1239 W MASON STGREEN BAY, WI, 543032047Browse WI providers · Browse ZIP 54303
- Phone
- 9204990696
- Fax
- 9204990697
- Primary Specialty
-
Dermatopathology
207ND0900X
- Additional Specialty
- Dermatopathology
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.