Dermatology at Winghaven, LLC

NPI #1982777413 in O Fallon, Missouri

Provider Information

NPI Number: 1982777413
Entity Type: Organization
Organization Name: Dermatology at Winghaven, LLC
Primary Specialty: Specialist
Enumeration Date: Nov 15, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 5551 WINGHAVEN BLVD
Address 2: STE 210
City: O Fallon
State: Missouri
ZIP Code: 63368-3617
Phone: (636) 561-4613

Authorized Official

Name: DR. RACHEL M QUALLEY, M.D.
Title: PHYSICIAN,OWNER
Phone: (636) 561-4613

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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