NPI 1154070738

Michael L Douglass, AA

Practitioner Anesthesiologist Assistant Summit, WI

Practice location

Address: 36500 Aurora Dr, Summit, WI 53066-4899
Phone: (262) 434-1000

Registered specialties

Anesthesiologist Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367H00000X Licence 209-17 (WI)

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Registry record

NPI: 1154070738
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Mar 2022
Record last updated: 14 Apr 2022

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.