Individual
MICHELLE S BULLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 MED TECH PKWY STE 180, JOHNSON CITY, TN 37604-2651
(423) 794-5540
(423) 926-9187
Mailing address
PO BOX 632476, CINCINNATI, OH 45263-2476
(423) 794-5540
(423) 926-9187
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
40966
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3812269
—
TN
Enumeration date
05/01/2006
Last updated
02/13/2025
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