Provider Demographics
NPI:1740397132
Name:BACHAMP, MONICA M (DO)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:M
Last Name:BACHAMP
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S SANTA FE
Mailing Address - Street 2:SUITE E
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401
Mailing Address - Country:US
Mailing Address - Phone:785-823-9518
Mailing Address - Fax:785-823-0575
Practice Address - Street 1:600 S SANTA FE
Practice Address - Street 2:SUITE E
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401
Practice Address - Country:US
Practice Address - Phone:785-823-9518
Practice Address - Fax:785-823-0575
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0526328207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100192570CMedicaid
KS053355OtherBCBS OF KANSAS
KS053355OtherBCBS OF KANSAS
KS100192570CMedicaid