Individual
DR. MICHAEL K MIKKELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
181 BLUFFTON RD BLDG G101G102, BLUFFTON, SC 29910-6221
(843) 757-5400
(843) 757-2240
Mailing address
PO BOX 2599, BLUFFTON, SC 29910-2599
(843) 757-5400
(843) 757-2240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15315
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153157
—
SC
Enumeration date
05/03/2006
Last updated
04/18/2013
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