Dr. Michael James Smullen
Dermatologist Dermatopathologist
1239 W Mason St
Green Bay
, Wisconsin 54303-2047
Dr. Michael James Smullen
Dermatologist Dermatopathologist
1239 W Mason St
Green Bay
, Wisconsin 54303-2047
(920) 499-0697
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About
Features
Specialties
- Dermatologist
- Dermatopathologist
Languages spoken
- English
Location
First Address
- Dr. Michael James Smullen
- 1239 W Mason St
- Green Bay, WI
- Zip : 54303-2047
- Fax : (920) 499-0697
- Phone : (920) 499-0696
Second Address
- Dr. Michael James Smullen
- 1239 W Mason St
- Green Bay, WI
- Zip : 54303-2047
- Fax : (920) 499-0697
- Phone : (920) 499-0696
Reviews
FAQs
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What type of doctor is Dr. Michael James Smullen
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Where is Dr. Michael James Smullen ’s practice located?
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Is Dr. Michael James Smullen a sole practitioner?
Is Dr. Michael James Smullen accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207N00000X | Dermatologist | WI16879 | WI |
| Y | 207ND0900X | Dermatopathologist | WI16879 | WI |
National Provider Identifier
| NPI | 1023020120 |
|---|---|
| Provider Name | Dr. Michael James Smullen |
| First Address | Green Bay, WI 54303-2047 |
| Second Address | Green Bay, WI 54303-2047 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/08/2006 |
| Last Update Date | 22/09/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 30979400 | (05) | WI |
| B56727 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.