St Charles County Dermatologic Surgery, LLC
NPI #1235761438 in Cottleville, Missouri
Provider Information
- NPI Number
- 1235761438
- Entity Type
- Organization
- Organization Name
- St Charles County Dermatologic Surgery, LLC
- Primary Specialty
- Dermatology - Procedural Dermatology
- Enumeration Date
- Feb 6, 2020
- Last Updated
- Feb 6, 2020
Practice Location
- Address
- 1493 COTTLEVILLE PKWY
- City
- Cottleville
- State
- Missouri
- ZIP Code
- 63376-3564
- Phone
- (636) 317-3376
Authorized Official
- Name
- STACEY S TULL, MD
- Title
- PHYSICIAN AND OWNER
- Phone
- (636) 327-3376
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dermatology - Procedural Dermatology — Procedural Dermatology |
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