MEDICARE: MICHELLE PARKER HUSTON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	146D00000X	Personal Emergency Response Attendant	D0058781	MD
2	207P00000X	Emergency Medicine Physician	2007016085	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	38931035	OTHER		BCBS

General Provider Information

NPI Number	:	1922164011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE PARKER HUSTON MD

Provider Business Mailing Address
First Line	:	PO BOX 78009
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63178-8009
Country	:	US
Telephone Number	:	866-898-7142
Fax Number	:	616-975-9824

Provider Business Practice Location Address
First Line	:	6516 SUMMIT ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64113-1821
Country	:	US
Telephone Number	:	816-932-2171
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2006
Last Update Date	:	12/26/2007

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Directions to “ MICHELLE PARKER HUSTON MD” Practice Location

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