| Dr Michael James Smullen, MD | |
|
1239 W Mason St, Green Bay, WI 54303-2047 | |
| (920) 499-0696 | |
| (920) 499-0697 |
| Full Name | Dr Michael James Smullen |
|---|---|
| Gender | Male |
| Speciality | Dermatology - Dermatopathology |
| Location | 1239 W Mason St, Green Bay, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023020120 | NPI | - | NPPES |
| 30979400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | WI16879 (Wisconsin) | Secondary |
| 207ND0900X | Dermatology - Dermatopathology | WI16879 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael James Smullen, MD 1239 W Mason St, Green Bay, WI 54303-2047 Ph: (920) 499-0696 | Dr Michael James Smullen, MD 1239 W Mason St, Green Bay, WI 54303-2047 Ph: (920) 499-0696 |
Frances Stahl Ballo, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2806 Riverview Dr, Green Bay, WI 54313 Phone: 920-498-7546 Fax: 920-569-4129 | |
Eduardo K Moioli, Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2845 Greenbrier Rd, Green Bay, WI 54311 Phone: 920-288-8000 | |
Dr. Daniel P Hertel, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2845 Greenbrier Rd, Green Bay, WI 54311 Phone: 920-288-8100 Fax: 920-288-8462 | |
Kevan G Lewis, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 3059 Voyager Dr, Green Bay, WI 54311 Phone: 920-965-0345 Fax: 920-257-4559 | |
Paul Michael Stover, MD Dermatology Medicare: Medicare Enrolled Practice Location: 2806 Riverview Dr, Green Bay, WI 54313 Phone: 920-498-7546 Fax: 920-569-4129 | |
Dr. Rene Martin Earles, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 2221 S Webster Ave, Ste 241, Green Bay, WI 54301 Phone: 920-965-0345 Fax: 920-273-6011 |