Individual
DR. SEBASTIAN A. RUECKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
901 E 5TH ST, WASHINGTON, MO 63090-3127
(636) 239-8011
Mailing address
901 E 5TH ST, WASHINGTON, MO 63090-3127
(636) 239-8011
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2008027335
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010H262530
BLUE CROSS-BLUE CROSS
—
05
—
036093636
—
IL
05
—
1356415863
—
MO
05
—
469031210
—
MI
01
—
SR075171
CHAMPUS-CHAMPUS
—
Enumeration date
11/17/2006
Last updated
01/09/2024
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