Provider Demographics
NPI:1619023645
Name:MICHAEL BELL, MD LLC
Entity Type:Organization
Organization Name:MICHAEL BELL, MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-264-7995
Mailing Address - Street 1:100A E PLEASANT ST
Mailing Address - Street 2:SUITE 1W2
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-3975
Mailing Address - Country:US
Mailing Address - Phone:414-264-7995
Mailing Address - Fax:414-265-7996
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:414-265-7996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI46791 020174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34558800Medicaid
WI252111416003OtherBCBS
WII16872Medicare UPIN
WI34558800Medicaid