Provider Demographics
NPI:1306817648
Name:SMOLEN, MELANIE L (MD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:L
Last Name:SMOLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:L
Other - Last Name:YUEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8550 MARSHALL DR STE 220
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1505
Mailing Address - Country:US
Mailing Address - Phone:816-348-2260
Mailing Address - Fax:913-495-3751
Practice Address - Street 1:7201 E 147TH ST
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:MO
Practice Address - Zip Code:64030-4204
Practice Address - Country:US
Practice Address - Phone:816-348-2260
Practice Address - Fax:913-495-3751
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMD 110558207Q00000X
MO110558207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOG96472Medicare UPIN
MOK674728Medicare PIN
MOP00330774Medicare PIN