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Individual
KELLY MOEDER
Active
Individual
KELLY MOEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-51057
KS
207QS0010X
Sports Medicine (Family Medicine) Physician
04-51057
KS
Other
Enumeration date
06/09/2021
Last updated
02/20/2026
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