Individual
DR. MICHAEL SHANE HULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
105 SO. BRYANT AVE, SUITE 104, EDMOND, OK 73034-6330
(405) 715-2022
(405) 715-2905
Mailing address
4900 S. MONACO ST, #210, DENVER, CO 80237-3486
(405) 715-2022
(405) 715-2905
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4302
OK
207RP1001X
Pulmonary Disease Physician
Primary
4302
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200070260A
—
OK
Enumeration date
01/26/2007
Last updated
03/28/2012
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