Provider Demographics
NPI:1659046530
Name:CALDERON MELENDEZ, MISAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MISAEL
Middle Name:
Last Name:CALDERON MELENDEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6299 NALL AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3547
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6299 NALL AVE STE 10
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-3547
Practice Address - Country:US
Practice Address - Phone:913-308-6221
Practice Address - Fax:913-308-6231
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-12
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020003793111N00000X
KS0106032111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty