Provider Demographics
NPI:1770538936
Name:BRITTON-MEHLISCH, MICHELLE RENE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:RENE
Last Name:BRITTON-MEHLISCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:RENE
Other - Last Name:BRITTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1301 SW ARBORWALK BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64082-4101
Mailing Address - Country:US
Mailing Address - Phone:816-537-6232
Mailing Address - Fax:816-537-9161
Practice Address - Street 1:1301A SW ARBORWALK BLVD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64082-4101
Practice Address - Country:US
Practice Address - Phone:816-537-6232
Practice Address - Fax:816-537-9161
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005019357207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100158720HMedicaid
MO1215987094Medicaid
MO1215987094Medicaid
G34352Medicare UPIN