Organization
MOELLER DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARAH BIRD (OFFICE MANAGER)
(316) 682-7546
Entity
Organization
Contact information
Practice address
1911 N WEBB RD, WICHITA, KS 67206-3405
(316) 682-7546
(316) 682-7554
Mailing address
1911 N WEBB RD, WICHITA, KS 67206-3405
(316) 682-7546
(316) 682-7554
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
04-21795
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100205810B
—
KS
05
—
100396180A
—
KS
05
—
100397800C
—
KS
05
—
100407240A
—
KS
05
—
200252100C
—
KS
Enumeration date
07/11/2005
Last updated
06/23/2015
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