Provider Demographics
NPI:1235180779
Name:BELL, MICHAEL ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:BELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:630 N 4TH ST
Mailing Address - Street 2:UNIT 610
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53203-2807
Mailing Address - Country:US
Mailing Address - Phone:414-347-0580
Mailing Address - Fax:414-264-7996
Practice Address - Street 1:100A E PLEASANT ST
Practice Address - Street 2:SUITE 1W2
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-3975
Practice Address - Country:US
Practice Address - Phone:414-264-7995
Practice Address - Fax:414-264-7996
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI467910202084P0800X
IL0361153722084P0800X
OH35.0965452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100136240Medicaid
WI1567913OtherUNITED HEALTH CARE
WI34558800Medicaid
IN100136240Medicaid
IN363920Medicare PIN
WI34558800Medicaid