NPI 1194148379

Michael J. Smullen, MD

Organisation Dermatology Physician Green Bay, WI

Practice location

Address: 1239 W Mason St, Green Bay, WI 54303-2047
Phone: (920) 499-0696
Fax: (920) 499-0697

Authorised official

Name: Michael J. Smullen
Title: Solo Practitioner
Phone: (920) 499-0696

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X

Other Dermatology providers in Wisconsin →

Registry record

NPI: 1194148379
Entity type: Organization
NPI issued: 24 Jan 2014
Record last updated: 24 Jan 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.