Provider Demographics
NPI:1851413397
Name:PERCHELLET, MELISSA ANN (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:PERCHELLET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:MARCHIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:211 NE 54TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-4390
Mailing Address - Country:US
Mailing Address - Phone:816-453-6777
Mailing Address - Fax:816-454-3601
Practice Address - Street 1:211 NE 54TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4390
Practice Address - Country:US
Practice Address - Phone:816-453-6777
Practice Address - Fax:816-454-3601
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110229632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOW20000003Medicare PIN