Individual
DR. MICHAEL JAMES SMULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
WI16879
WI
207ND0900X
Dermatopathology Physician
Primary
WI16879
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30979400
—
WI
Enumeration date
08/13/2006
Last updated
09/22/2010
Update your record
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