Lake St Louis Dermatology PC
Lake St Louis Dermatology PC provides Dermatology Physician services in Lake St Louis, Missouri. Licensed in Missouri. Registered with an NPI since 2008.
- Licensed in
- MO
- In the registry since
- 2008
What do these letters mean?
- PC — Professional corporation
- A form of business registration, not a clinical qualification.
Practice location Address checks out
300 Medical Plz Mob 2 Ste 210Lake St Louis, MO 63367-1481 Not confirmed with CMS for 17 years — call before visiting
Phone: (636) 561-0026
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dermatology Physician (primary) | Taxonomy 207N00000X · Licence MO2002031471 (MO) |
|---|
Record details
| NPI number | 1255583746 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Maria Canizares-Heyde — Dermatologist · (636) 561-0026 |
| NPI enumerated | October 16, 2008 |
| Last updated in NPPES | February 11, 2009 |
| Mailing address | 300 Medical Plz, Mob 2, Suite 210, Lake St Louis, MO 63367-1481 |
Other providers in Lake St Louis
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Dr. Maria Jean Canizares, MD
300 Medical Plz Mob 2 Ste 210, Lake St Louis, MO 63367-1481 · (636) 561-0026