SUSAN F MICKEL M.D. PH.D. NPI 1356441018

NPI Information

NPI: 1356441018
Provider Name: SUSAN F MICKEL, M.D., PH.D.
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

PECOS Registration: Yes

Address:
1717 TAYLOR AVE
RACINE, WI
ZIP 53403
Phone: (262) 638-6744
Get Directions

Susan F Mickel, M.D., PH.D. is a neurology psychiatry neurology in Racine, WI. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. Susan F Mickel, M.D., PH.D. NPI is 1356441018. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1717 TAYLOR AVE
RACINE, WI
ZIP 53403-405
Phone: (262) 638-6744
Fax: (262) 638-6540

The NPI 1356441018 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 9/23/2006 and was last updated on 8/22/2013.

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
1	103T00000X	Psychologist		3113-57	WISCONSIN	No
2	2084N0400X	Psychiatry & Neurology	Neurology	28735	WISCONSIN	Yes

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
1	021572200	MEDICARE ID-TYPE UNSPECIFIED	WISCONSIN
2	B55084	MEDICARE UPIN
3	322500129	MEDICARE PIN	WISCONSIN
4	1356441018	MEDICAID	WISCONSIN

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: 5/5/2024

NPI Synchronization or Removal

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