Provider Demographics
NPI:1528424637
Name:POPPA, MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:POPPA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6700 SQUIBB RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-3230
Mailing Address - Country:US
Mailing Address - Phone:913-345-0550
Mailing Address - Fax:913-403-8955
Practice Address - Street 1:6700 SQUIBB RD
Practice Address - Street 2:SUITE 105
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-3230
Practice Address - Country:US
Practice Address - Phone:913-345-0550
Practice Address - Fax:913-403-8955
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS185282083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine