Individual
JOEL MAURICE FEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4601 INDEPENDENCE AVE, KANSAS CITY, MO 64124
(816) 753-5144
(816) 753-0804
Mailing address
3515 BROADWAY BLVD, KANSAS CITY, MO 64111-2501
(816) 753-5144
(816) 753-0804
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
05-16907
KS
207Q00000X
Family Medicine Physician
Primary
R7325
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200031852
—
MO
01
—
57321013
BCBS
MO
Enumeration date
04/17/2006
Last updated
11/06/2018
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