Provider Demographics
NPI:1477177251
Name:MENEGUS, STEVEN (RD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:MENEGUS
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5532 BUTTERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-8720
Mailing Address - Country:US
Mailing Address - Phone:925-899-8450
Mailing Address - Fax:
Practice Address - Street 1:5532 BUTTERFIELD DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-8720
Practice Address - Country:US
Practice Address - Phone:925-899-8450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86112841133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered