Provider Demographics
NPI:1437132503
Name:VOLWEIDER, FREDERICK H (LP LICENSED PSYCHOLO)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:H
Last Name:VOLWEIDER
Suffix:
Gender:M
Credentials:LP LICENSED PSYCHOLO
Other - Prefix:
Other - First Name:RICK
Other - Middle Name:
Other - Last Name:VOLWEIDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1900 N AMIDON
Mailing Address - Street 2:STE 200
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203
Mailing Address - Country:US
Mailing Address - Phone:316-558-8085
Mailing Address - Fax:316-558-8086
Practice Address - Street 1:1900 N AMIDON
Practice Address - Street 2:STE 200
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-2125
Practice Address - Country:US
Practice Address - Phone:316-558-8085
Practice Address - Fax:316-558-8086
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0919103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
060708Medicare ID - Type Unspecified