Provider Demographics
NPI:1215307384
Name:PAAKH, MICHELLE ELISABETH (CPM)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ELISABETH
Last Name:PAAKH
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8122 W WESTLAKES ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1931
Mailing Address - Country:US
Mailing Address - Phone:316-304-3056
Mailing Address - Fax:
Practice Address - Street 1:8122 W WESTLAKES ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1931
Practice Address - Country:US
Practice Address - Phone:316-304-3056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-02
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS97100005207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics