Provider Demographics
NPI:1659482057
Name:BATES, MICHAEL N (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:N
Last Name:BATES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-9013
Mailing Address - Country:US
Mailing Address - Phone:316-283-4153
Mailing Address - Fax:316-282-0550
Practice Address - Street 1:700 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 120
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-9013
Practice Address - Country:US
Practice Address - Phone:316-283-4153
Practice Address - Fax:316-282-0550
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0416926207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
058878Medicare PIN
110296Medicare PIN
160050904Medicare PIN
B68983Medicare UPIN