Individual
DR. OSWALD LIGHTSEY MIKELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
11219
SC
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
11219
SC
207NS0135X
Procedural Dermatology Physician
11219
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112194
—
SC
Enumeration date
06/12/2006
Last updated
08/17/2016
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