Organization
MICHAEL L CULLEN MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL L CULLEN M.D. (OWNER)
(309) 797-6611
Entity
Organization
Contact information
Practice address
4326 7TH ST, MOLINE, IL 61265-6867
(309) 797-6611
(309) 797-7181
Mailing address
4326 7TH ST, MOLINE, IL 61265-6867
(309) 797-6611
(309) 797-7181
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
BLUE CROSS BLUE SHIELD
IL
01
—
094843
IOWA MEDICAID
IA
Enumeration date
04/02/2007
Last updated
06/26/2008
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