Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 2004018707 | MO |
Y | 222Z00000X | Podiatrist | 2004018707 | MO |
N | 213EP1101X | Primary Podiatric Medicine | 2004018707 | MO |
N | 213ES0103X | Foot & Ankle Surgery | 016-005149 | IL |
NPI | 1366422115 |
---|---|
Provider Name | Dr. Erica L Torgrude |
First Address | Webster Groves, MO 63119-2103 |
Second Address | Webster Groves, MO 63119-2103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2006 |
Last Update Date | 14/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MA5031010 | MEDICARE NUMBER (01) | MO |
U99175 | (02) | IL |