Individual
DR. MICHAEL D SIMISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
37768
IA
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
37768
IA
2084P0800X
Psychiatry Physician
Primary
37768
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
074570002
MEDICARE PTAN
—
Enumeration date
05/21/2007
Last updated
02/14/2017
Update your record
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