ST. LOUIS DERMATOLOGY CENTER LLC (NPI# 1437667920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437667920 |
| Entity Type | Organization |
| Organization Name | ST. LOUIS DERMATOLOGY CENTER LLC |
| Practice Address |
8888 Ladue Rd Ste 210 Saint Louis MO 63124-2056 |
| Mailing Address |
536 Rosedale Ave Apt 201 Saint Louis MO 63112-1427 |
| Practice Telephone | 3144740114 |
| Practice Fax Number | 3145262686 |
| Mailing Telephone | 3342212357 |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2018-01-18 |
| Authorized Official Name | OSAMUEDE OSEMWOTA (OWNER) |
| Authorized Official Telephone | 3144740114 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 2017039492 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
8888 LADUE RD STE 210 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63124-2056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003894775 | Amy Elizabeth Roberts | Family Medicine | 8888 Ladue Rd Ste 210, Saint Louis, MO 63124-2056 | 2006-01-04 |
| 1881044402 | Candace Sue Counts | Nurse Practitioner | 8888 Ladue Rd Ste 210, Saint Louis, MO 63124 | 2016-06-14 |
| 1982085759 | Desirai Ann Rogan | Internal Medicine | 8888 Ladue Rd Ste 210, Saint Louis, MO 63124 | 2015-06-17 |
| 1700014651 | Sukepma Giri | Family Medicine | 8888 Ladue Rd Ste 210, Saint Louis, MO 63124-2056 | 2009-06-30 |
| 1669452496 | Carl A. Lyss | Internal Medicine | 8888 Ladue Rd Ste 210, Suite 210, Saint Louis, MO 63124-2056 | 2006-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174174775 | Nicholas Simpson | Nurse Practitioner | 8857 Ladue Road, St. Louis, MO 63124 | 2019-09-25 |
| 1144774647 | Carolyn Ashley Myles Versical | Psychologist | 26 Godwin Ln, Saint Louis, MO 63124 | 2016-08-12 |
| 1740669373 | Victor's Home Care Cds, LLC | Hospice Care, Community Based | 8420 Delmar Blvd, Ste 507, St. Louis, MO 63124 | 2015-05-28 |
| 1851784490 | Bryan Watanabe Dds Ladue Dental Group, PC | Dentist | 8859 Ladue Road, Ladue, MO 63124 | 2015-03-06 |
| 1689072324 | Ladue Internal Medicine, LLC | Internal Medicine | 8857 A Ladue Rd., Ladue, MO 63124 | 2014-12-11 |
| 1043557150 | Ronald Nathan Riner | Internal Medicine | 9847 Waterbury Drive, St. Louis, MO 63124 | 2013-01-09 |
| 1295099638 | David Stuart Sonderman | Pediatrics | 8888 Ladue Road, Ste 100, Saint Louis, MO 63124 | 2012-06-29 |
| 1255637799 | Kyu S Her | Pediatrics | 624 Haverford Road, St. Louis, MO 63124 | 2011-02-01 |
| 1194983833 | Roberte Kuhlman | Orthopaedic Surgery | 12 Upper Barnes, St Louis, MO 63124 | 2008-05-29 |
| 1467507673 | Mark William Aylward | Dentist | 9216 Clayton Road, Suite 118, St Louis, MO 63124 | 2007-01-25 |
| Find all providers in zip 63124 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922605906 | Deluxe Dermatology LLC | Dermatology | 1034 S Brentwood Blvd Ste 1000, Saint Louis, MO 63117-1210 | 2020-10-03 |
| 1417597923 | Anna Marie Aiazzi | Dermatology | 10012 Kennerly Rd Ste 401, Saint Louis, MO 63128-2197 | 2020-01-13 |
| 1821482373 | David Cotter | Dermatology | 9450 Minerva Ave, Saint Louis, MO 63114-3910 | 2015-03-23 |
| 1710320767 | Mallory Shiver Abate | Dermatology | 1755 S Grand Blvd Dept of Dermatology, Saint Louis, MO 63104-1540 | 2013-04-09 |
| 1689935728 | Rebecca Joy Chibnall | Dermatology | 5225 Mid America Plz Ste 2300, Ste 2300, Saint Louis, MO 63129-0002 | 2012-06-05 |
| 1285928697 | Urvi Patel | Dermatology | 522 N New Ballas Rd Ste 316, Ste 316, Saint Louis, MO 63141-6840 | 2011-06-02 |
| 1235428582 | Hala Fatima Adil | Dermatology | 2315 Dougherty Ferry Rd Ste 200b, Slucare Dermatology, Saint Louis, MO 63122-3383 | 2011-04-06 |
| 1376852087 | Michael Slade Stratton | Dermatology | 2325 Dougherty Ferry Rd Ste 201, Saint Louis, MO 63122-3356 | 2010-09-29 |
| 1255643813 | Sarah Alison Finger Basak | Dermatology | 12855 N 40 Dr Ste 180, Saint Louis, MO 63141-8657 | 2010-07-11 |
| 1285835454 | Nita Kohli | Dermatology | 4901 Forest Park Ave Ste 502, Ste 502, Saint Louis, MO 63108-1402 | 2007-05-29 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63124 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.