Provider Demographics
NPI:1003187964
Name:MONICA M BACHAMP DO PA
Entity Type:Organization
Organization Name:MONICA M BACHAMP DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDEN
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BACHAMP
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:785-823-9518
Mailing Address - Street 1:PO BOX 1637
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-8637
Mailing Address - Country:US
Mailing Address - Phone:785-823-9518
Mailing Address - Fax:785-823-0575
Practice Address - Street 1:600 S SANTA FE AVE
Practice Address - Street 2:SUITE E
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4148
Practice Address - Country:US
Practice Address - Phone:785-823-9518
Practice Address - Fax:785-823-0575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0526328207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty