MEDICARE: DR. TERRI LYNN RIUTCEL 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	2084F0202X	Forensic Psychiatry Physician	2010038105	MO
2	2084P0800X	Psychiatry Physician	2010038105	MO
3	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician	2010038105	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386633360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRI LYNN RIUTCEL MD

Provider Business Mailing Address
First Line	:	660 S EUCLID AVE
Second Line	:	CB 8111
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1010
Country	:	US
Telephone Number	:	314-362-1408
Fax Number	:	314-747-3813

Provider Business Practice Location Address
First Line	:	1600 S BRENTWOOD BLVD
Second Line	:	DIV NEUROLOGY SLEEP MED, STE 600
City	:	SAINT LOUIS
State	:	MO
Zip	:	63144-1320
Country	:	US
Telephone Number	:	314-362-1408
Fax Number	:	314-747-4342

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	11/15/2021

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