MICHAEL J. SMULLEN, MD
NPI 1194148379
Dermatology in Green Bay, WI

Active since January 24, 2014
1239 W MASON ST, GREEN BAY, WI 54303(920) 499-0696(920) 499-0697 Get Directions Write a Review

NPPES record last updated: January 24, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Michael J. Smullen, Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL J. SMULLEN, MD (NPI 1194148379) is a healthcare organization registered as a dermatology in Green Bay, Wisconsin and active in the NPI registry since January 2014. The organization lists Michael J. Smullen, Solo Practitioner, as its authorized official.

NPPES Registry Identity

NPI1194148379
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameMICHAEL J. SMULLEN, MD
Location Address1239 W MASON STGreen Bay, WI 54303-2047
Mailing Address1239 W Mason StGreen Bay, WI 54303-2047 · (920) 499-0696 · Fax (920) 499-0697
Fax(920) 499-0697
Organization SubpartNo
Authorized OfficialMichael J. SmullenSolo Practitioner · (920) 499-0696
Enumeration DateJanuary 24, 2014
NPI 1194148379 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

1239 W MASON ST, Green Bay, WI 54303

Other Identifiers 2

Medicaid30979400WI
Medicare UPINB56727WI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dermatology (Dermatopathology)
1239 W MASON ST
GREEN BAY, WI 54303
Chiropractor
1239 W MASON ST
GREEN BAY, WI 54303
Chiropractor
1239 W MASON ST
GREEN BAY, WI 54303
Chiropractor
1239 W MASON ST
GREEN BAY, WI 54303
Chiropractor
1239 W MASON ST
GREEN BAY, WI 54303

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael J. Smullen, MD's NPI number?

The NPI number for Michael J. Smullen, MD is 1194148379. It was assigned to this organization in the NPPES registry on January 24, 2014.

Where is Michael J. Smullen, MD located?

Michael J. Smullen, MD is located at 1239 W Mason St, Green Bay, WI 54303. The listed phone number is (920) 499-0696.

What is Michael J. Smullen, MD's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

When was this NPI record last updated?

The NPPES record for Michael J. Smullen, MD was last updated on January 24, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.