Provider Demographics
NPI:1457355216
Name:BYRAM, MELANIE S (MD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:S
Last Name:BYRAM
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 1:930 HAYES DRIVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502
Mailing Address - Country:US
Mailing Address - Phone:785-565-0016
Mailing Address - Fax:785-565-0003
Practice Address - Street 1:930 HAYES DRIVE
Practice Address - Street 2:SUITE B
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502
Practice Address - Country:US
Practice Address - Phone:785-565-0016
Practice Address - Fax:785-565-0003
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS22333207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS101142OtherBLUE CROSS BLUE SHIELD
KS460855OtherCHILDRENS MERCY FAMILY HP
KS100119380BMedicaid
KS101142Medicare ID - Type Unspecified
KS101142OtherBLUE CROSS BLUE SHIELD