MEDICARE: VRUTA S KANSARA 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	208M00000X	Hospitalist Physician	036179356	IL
2	207R00000X	Internal Medicine Physician	2023020079	MO

General Provider Information

NPI Number	:	1366127177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VRUTA S KANSARA MD

Provider Business Mailing Address
First Line	:	660 S EUCLID AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1010
Country	:	US
Telephone Number	:	314-362-8065
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BARNES JEWISH HOSPITAL PLZ
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1003
Country	:	US
Telephone Number	:	314-362-8065
Fax Number	:

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

Provider Enumeration Date	:	06/19/2023
Last Update Date	:	06/02/2026

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Directions to “ VRUTA S KANSARA MD” Practice Location

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