Provider Demographics
NPI:1306473012
Name:MOLITORIS, ANDREW STEPHEN (DO)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:STEPHEN
Last Name:MOLITORIS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:3901 RAINBOW BLVD # MS 4015
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8500
Mailing Address - Country:US
Mailing Address - Phone:913-588-6400
Mailing Address - Fax:913-588-6414
Practice Address - Street 1:BEHAVIORAL HEALTHCARE
Practice Address - Street 2:3425 MELROSE RD
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-1608
Practice Address - Country:US
Practice Address - Phone:910-615-3600
Practice Address - Fax:910-615-3784
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-24
Last Update Date:2025-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS05-479602084P0800X
390200000X
NC2024-021032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program