Provider Demographics
NPI:1982689006
Name:MIKE, MARGARET ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:MIKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:1020 HITT ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-0001
Practice Address - Country:US
Practice Address - Phone:573-882-1515
Practice Address - Fax:573-884-0070
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2686103G00000X, 2084N0400X, 2084S0012X
MO20210441572084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX033941801Medicaid
TX1982689006Medicaid
TX033941802Medicaid
TX033941804Medicaid
TX033941806Medicaid
TX033941808Medicaid
TX033941807Medicaid
TXTXB122558Medicare PIN
TX033941801Medicaid
TX1982689006Medicaid
TXTXB122458Medicare PIN