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General NPI Number Information
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NPI Number | 1588677991
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Entity Type | Individual
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Provider Name | MELISSA C ALTOM MD
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Gender | Female
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 10/13/2023
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Provider Practice Location Address
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Address Line | 106 COMMERCE DR
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City | AURORA
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State | MO
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Zip | 65605-6260
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Country | US
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Telephone | 417-269-2400
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Fax | 417-269-2410
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Provider Business Mailing Address
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Address Line | PO BOX 802843
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City | KANSAS CITY
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State | MO
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Zip | 64180-2843
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Country | US
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Telephone | 417-730-6430
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Fax | 417-269-7567
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 112771
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License Number State | MO
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