Individual
MARIE L. MICHELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
250 PARK ST, BOWLING GREEN, KY 42101-1760
(270) 745-1323
(270) 745-1332
Mailing address
PO BOX 9961, BOWLING GREEN, KY 42102-4961
(270) 745-1467
(270) 745-1417
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
28546
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64285463
—
KY
Enumeration date
08/23/2005
Last updated
08/24/2007
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