Healthcare Provider Details

I. General information

NPI: 1457522351
Provider Name (Legal Business Name): KATE MICHELLE DOVE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 02/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 COLLEGE AVE STE G-210
MANHATTAN KS
66502-2770
US

IV. Provider business mailing address

1133 COLLEGE AVE STE G-210
MANHATTAN KS
66502-2770
US

V. Phone/Fax

Practice location:
  • Phone: 785-537-9030
  • Fax:
Mailing address:
  • Phone: 785-537-9030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2007001557
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: