DR. MICHAEL JAMES SMULLEN MD NPI 1023020120

NPI Information

  • NPI: 1023020120
  • Provider Name: DR. MICHAEL JAMES SMULLEN, MD
  • Classification: Dermatology - 207ND0900X
  • Specialization: Dermatopathology
  • Entity Type: Individual
  • Address: 1239 W MASON ST
    GREEN BAY, WI
    ZIP 54303
  • Phone: (920) 499-0696

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NPI Details

DR. Michael James Smullen, MD is a dermatopathology dermatology in Green Bay, WI. The provider is a dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. DR. Michael James Smullen, MD NPI is 1023020120. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1239 W MASON ST
GREEN BAY, WI
ZIP 54303-047
Phone: (920) 499-0696
Fax: (920) 499-0697

The enumeration date for this NPI number is 8/13/2006 and was last updated on 9/22/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207N00000XDermatologyWI16879WISCONSINNo
2207ND0900XDermatologyDermatopathologyWI16879WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1B56727MEDICARE UPIN
230979400MEDICAIDWISCONSIN
307052MEDICARE ID-TYPE UNSPECIFIEDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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