Healthcare Provider Details
I. General information
NPI: 1023099694
Provider Name (Legal Business Name): CATHERINE REMUS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/09/2005
Last Update Date: 09/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13303 TESSON FERRY RD SUITE 150
SAINT LOUIS MO
63128-4062
US
IV. Provider business mailing address
PO BOX 23340
SAINT LOUIS MO
63156-3340
US
V. Phone/Fax
- Phone: 314-842-5239
- Fax: 314-842-3835
- Phone: 314-842-5239
- Fax: 314-842-3835
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 36730 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: