Michael James Lynch, M.D.
Individual provider Active NPI Internal Medicine Physician · Deerbrook, WI
NPI 1821139429 · NPPES record last updated Aug 1, 2012
Key facts
- NPI
- 1821139429
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 24081 (WI)
- Practice address
- N8985 S Shore LN
Deerbrook, WI 54424-9657 - Phone
- (715) 610-5049
- NPI assigned
- Feb 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24081 | WI | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 24081 | WI | Yes |
Addresses
Primary practice location
N8985 S Shore LN
Deerbrook, WI 54424-9657
Mailing address
N8985 S Shore LN
Deerbrook, WI 54424-9657
Phone (715) 610-5049
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.