Individual
DIANE M RUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13065 OLD TESSON FERRY RD, SAINT LOUIS, MO 63128-3441
(314) 270-3081
(314) 270-3084
Mailing address
13065 OLD TESSON FERRY RD, SAINT LOUIS, MO 63128-3441
(314) 270-3081
(341) 270-3087
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
103826
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208019612
—
MO
Enumeration date
02/22/2007
Last updated
04/01/2010
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