Provider Demographics
NPI:1386633360
Name:RIUTCEL, TERRI LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRI
Middle Name:LYNN
Last Name:RIUTCEL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:CB 8111
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-1408
Mailing Address - Fax:314-747-3813
Practice Address - Street 1:1600 S BRENTWOOD BLVD
Practice Address - Street 2:DIV NEUROLOGY SLEEP MED, STE 600
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63144-1320
Practice Address - Country:US
Practice Address - Phone:314-362-1408
Practice Address - Fax:314-747-4342
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2021-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO20100381052084F0202X, 2084P0800X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO204429401Medicaid
ILENROLLEDMedicaid