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Individual

DR. DANIEL M SMULLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8901 W LINCOLN AVE, 2ND FL, WEST ALLIS, WI 53227-2409
(414) 329-4300
Mailing address
8901 W LINCOLN AVE, 2ND FL, WEST ALLIS, WI 53227-2409
(414) 329-4300

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
46773-020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1043245376
WI
01
P00352772
RAIL ROAD MEDICARE
Enumeration date
07/12/2006
Last updated
11/23/2021
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