Healthcare Provider Details

I. General information

NPI: 1538715354
Provider Name (Legal Business Name): KATHARINE M RUG MS, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2019
Last Update Date: 08/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1177 NORTH WARSON RD
ST. LOUIS MO
63132
US

IV. Provider business mailing address

1177 NORTH WARSON RD
ST. LOUIS MO
63132
US

V. Phone/Fax

Practice location:
  • Phone: 314-817-2262
  • Fax: 314-569-0778
Mailing address:
  • Phone: 314-817-2262
  • Fax: 314-569-0778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: