Individual
DR. MICHAEL L CULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036078998
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036078998
—
IL
01
—
08100424
BCBS IL
IL
01
—
094843
MEDICAID
IA
Enumeration date
11/11/2005
Last updated
06/16/2008
Update your record
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