NPI 1023020120

Michael James Smullen, MD

Practitioner Dermatopathology Physician Green Bay, WI

Practice location

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

Registered specialties (2)

Dermatopathology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207ND0900X Licence WI16879 (WI)

Other Dermatology providers in Wisconsin →

Dermatology Physician

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence WI16879 (WI)

Registry record

NPI: 1023020120
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Aug 2006
Record last updated: 22 Sep 2010

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.