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NPI Code Detail

MEDICARE: FAITH WRIGHT RD

MEDICARE: FAITH WRIGHT RD
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
1133V00000XRegistered Dietitian2023027065MO

Other Identifiers

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

General Provider Information

NPI Number : 1649959347
Entity Type Code : Individual
Provider Name (Legal Business Name) : FAITH WRIGHT RD
Provider Business Mailing Address
First Line : 50 CRESTWOOD EXECUTIVE CTR STE 500
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63126-1948
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 50 CRESTWOOD EXECUTIVE CTR STE 500
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63126-1948
Country : US
Telephone Number : 636-229-1977
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2023
Last Update Date : 03/30/2026

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Directions to “ FAITH WRIGHT RD” Practice Location

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