Provider Demographics
NPI:1194952358
Name:PARUCH, JOHN T (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:T
Last Name:PARUCH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11155 DUNN RD STE 312E
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-6111
Mailing Address - Country:US
Mailing Address - Phone:314-953-8500
Mailing Address - Fax:314-355-1070
Practice Address - Street 1:11155 DUNN RD
Practice Address - Street 2:STE 312E
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-6150
Practice Address - Country:US
Practice Address - Phone:314-953-8500
Practice Address - Fax:314-355-1070
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2021-03-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2014024912207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine