Dermatology At Winghaven, Llc in O Fallon - Specialist
Dermatology At Winghaven, Llc - NPI 1982777413
Dermatology At Winghaven, Llc is a Specialist in O Fallon, Missouri. Dermatology At Winghaven, Llc practices all healthcare services and medical treatments related to Specialist. The NPI Number for Dermatology At Winghaven, Llc is 1982777413. The last update date is 2020-08-22.
Dermatology At Winghaven, Llc's current location address is 5551 Winghaven Blvd, O Fallon, Missouri. You can contact this provider via phone number 6365614613 and fax number 6365614610. The mailing address for Dermatology At Winghaven, Llc is 5551 Winghaven Blvd, O Fallon, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Dermatology At Winghaven, Llc |
|---|---|
| Address | 5551 Winghaven Blvd, O Fallon, Missouri |
| Phone Number | 6365614613 |
| Fax Number | 6365614610 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PHYSICIAN, |
|---|---|
| Authorized Official Name | Qualley M Rachel |
| Credentials | M.D. |
| Telephone Number | 6365614613 |
NPI Number Detail
| NPI Number | 1982777413 |
|---|---|
| Provider Enumeration Date | 2006-11-15 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 5551 Winghaven Blvd |
|---|---|
| City | O Fallon |
| State | Missouri (MO) |
| Post Code | 633683617 |
| Phone Number | 6365614613 |
| Fax Number | 6365614610 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 2004011011 |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Post Comment/ Review Below
What is the Dermatology At Winghaven, Llc's 1982777413?
The Dermatology At Winghaven, Llc's NPI (National Provider Identifier) Number is 1982777413. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Dermatology At Winghaven, Llc's facilities are geographically located?
The facilities of Dermatology At Winghaven, Llc are physically situated at the following location: 5551 Winghaven Blvd, O Fallon, MO, 633683617.
What is Dermatology At Winghaven, Llc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Dermatology At Winghaven, Llc's area of specialization is Specialist, and the corresponding taxonomy code that categorizes this field of practice is 174400000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1982777413 to Dermatology At Winghaven, Llc?
The Dermatology At Winghaven, Llc received its 1982777413 assignment from the Centers for Medicare & Medicaid Services on 2006-11-15.
When was the information pertaining to Dermatology At Winghaven, Llc most recently updated or revised?
The details related to Dermatology At Winghaven, Llc, including its address, specialty, and other relevant information, were last updated or revised on 2020-08-22.