Individual
MICHAEL D MICHENER
Active
Individual
MICHAEL D MICHENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
036114135
IL
207N00000X
Dermatology Physician
Primary
129488
AK
207Q00000X
Family Medicine Physician
036-114135
IL
Other
Enumeration date
09/22/2005
Last updated
08/13/2019
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