Individual
FREDERICK A ULAM III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, LP
Contact information
Practice address
516 E CATALPA ST, SPRINGFIELD, MO 65807-1614
(417) 864-8920
Mailing address
516 E CATALPA ST, SPRINGFIELD, MO 65807-1614
(417) 864-8920
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PYR0452
MO
103TA0700X
Adult Development & Aging Psychologist
PYR0452
MO
103TB0200X
Cognitive & Behavioral Psychologist
PYR0452
MO
103TC0700X
Clinical Psychologist
Primary
PYR0452
MO
103TC0700X
Clinical Psychologist
R0452
MO
103TR0400X
Rehabilitation Psychologist
PYR0452
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
495011611
—
MO
01
—
P00174113
RAILROAD MEDICARE
MO
Enumeration date
10/24/2006
Last updated
04/29/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us