Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Michael James Smullen, MD

Individual provider Dermatology Physician · NPI 1023020120

Dr. Michael James Smullen, MD is a Dermatology Physician in Green Bay, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1239 W Mason St
Green Bay, WI 54303-2047 Not confirmed with CMS for 16 years — call before visiting
Phone: (920) 499-0696
Fax: (920) 499-0697
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatopathology Physician (primary) Taxonomy 207ND0900X · Licence WI16879 (WI)
Dermatology Physician Taxonomy 207N00000X · Licence WI16879 (WI)

Record details

NPI number1023020120
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedAugust 13, 2006
Last updated in NPPESSeptember 22, 2010

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