Healthcare Provider Details

I. General information

NPI: 1245386226
Provider Name (Legal Business Name): STEVEN L LARUE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9705 LENEXA DR
LENEXA KS
66215-1345
US

IV. Provider business mailing address

9705 LENEXA DR
LENEXA KS
66215-1345
US

V. Phone/Fax

Practice location:
  • Phone: 913-396-8509
  • Fax: 913-318-8378
Mailing address:
  • Phone: 913-396-8509
  • Fax: 913-318-8378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number113114
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number113114
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number04-41424
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number04-41424
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: