Individual
MICHAEL TODD SHULL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
881 USS JAMES MADISON RD, KINGS BAY, GA 31547-2531
(912) 573-2410
Mailing address
108 HONEYSUCKLE RD, KINGSLAND, GA 31548-6486
(912) 576-8169
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/03/2006
Last updated
07/08/2007
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