St Louis Dermatology LLC
St Louis Dermatology LLC provides Dermatology Physician services in Fenton, Missouri. Licensed in Missouri. Registered with an NPI since 2013.
- Licensed in
- MO
- In the registry since
- 2013
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1011 Bowles Ave Ste 121Fenton, MO 63026-2387 Not confirmed with CMS for 12 years — call before visiting
Phone: (314) 200-2713
Fax: (314) 200-2714
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dermatology Physician (primary) | Taxonomy 207N00000X · Licence 2001020599 (MO) |
|---|
Record details
| NPI number | 1760810543 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Jeffrey Petersen — Owner · (314) 200-2713 |
| NPI enumerated | October 14, 2013 |
| Last updated in NPPES | February 18, 2014 |
| Mailing address | 1011 Bowles Avenue, Suite 121, Fenton, MO 63026-2387 |
Other providers in Fenton
-
Dr. Jeffrey E Petersen, MD
1011 Bowles Ave Ste 121, Fenton, MO 63026-2395 · (314) 200-2713