MEDICARE: DR. STEVEN L LARUE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZC0500X	Cytopathology Physician	113114	MO
2	207ZP0101X	Anatomic Pathology Physician	113114	MO

General Provider Information

NPI Number	:	1245386226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN L LARUE MD

Provider Business Mailing Address
First Line	:	660 S EUCLID AVE
Second Line	:	C B 8118
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1010
Country	:	US
Telephone Number	:	314-273-1884
Fax Number	:	314-362-0369

Provider Business Practice Location Address
First Line	:	425 S EUCLID AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1005
Country	:	US
Telephone Number	:	314-273-1884
Fax Number	:	314-362-0369

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	01/24/2018

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