Individual
MICHAEL SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1607 N BRIARCLIFF DR, APPLETON, WI 54915-2838
(920) 380-9916
Mailing address
1607 N BRIARCLIFF DR, APPLETON, WI 54915-2838
(920) 380-9916
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
42159
WI
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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