Provider Demographics
NPI:1336218536
Name:ZEHR, MARTIN DALE (PHD, JD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:DALE
Last Name:ZEHR
Suffix:
Gender:M
Credentials:PHD, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 COLLEGE BLVD.
Mailing Address - Street 2:SUITE 250
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1944
Mailing Address - Country:US
Mailing Address - Phone:913-451-8550
Mailing Address - Fax:913-469-5266
Practice Address - Street 1:7501 COLLEGE BLVD.
Practice Address - Street 2:SUITE 250
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1944
Practice Address - Country:US
Practice Address - Phone:913-451-8550
Practice Address - Fax:913-469-5266
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1281103G00000X
MOR0052103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSKS34652017OtherBCBS
MOKS34652017OtherBCBS
MON469927Medicare ID - Type Unspecified
KSC589927Medicare ID - Type Unspecified
MOC589927Medicare ID - Type Unspecified
KSKS34652017OtherBCBS