Provider Demographics
NPI:1013234137
Name:ALDERS, MICHELLE RENEE (DO)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RENEE
Last Name:ALDERS
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 1:57950 LEAVENWORTH ST BLDG 250
Mailing Address - Street 2:
Mailing Address - City:MCCONNELL AFB
Mailing Address - State:KS
Mailing Address - Zip Code:67221-3505
Mailing Address - Country:US
Mailing Address - Phone:316-759-5050
Mailing Address - Fax:
Practice Address - Street 1:57950 LEAVENWORTH ST BLDG 250
Practice Address - Street 2:
Practice Address - City:MCCONNELL AFB
Practice Address - State:KS
Practice Address - Zip Code:67221-3505
Practice Address - Country:US
Practice Address - Phone:316-759-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102203014207R00000X, 207RP1001X, 207R00000X
KS05-44593207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease