Individual
DAVID VICTOR SMULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3750
(414) 259-9290
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-3750
(414) 259-9290
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
68727
WI
2085R0202X
Diagnostic Radiology Physician
ME92285
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912969510
—
WI
05
—
275198400
—
FL
Enumeration date
04/06/2006
Last updated
05/01/2018
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