Healthcare Provider Details

I. General information

NPI: 1417535410
Provider Name (Legal Business Name): CHRISTOPHER STEPHEN MOYER DO, MHA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23351 PRAIRIE STAR PKWY STE A245
LENEXA KS
66227-7301
US

IV. Provider business mailing address

23351 PRAIRIE STAR PKWY STE A245
LENEXA KS
66227-7301
US

V. Phone/Fax

Practice location:
  • Phone: 913-676-8630
  • Fax: 913-676-8635
Mailing address:
  • Phone: 913-676-8630
  • Fax: 913-676-8635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number05-49739
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: