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EPIPHANY DERMATOLOGY OF MISSOURI LLC NPI 1528573342


NPI Information

NPI: 1528573342
Provider Name: EPIPHANY DERMATOLOGY OF MISSOURI, LLC
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 26D2144792

Address:
2325 DOUGHERTY FERRY RD STE 201
SAINT LOUIS, MO
ZIP 63122
Phone: (314) 993-1714
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EPIPHANY DERMATOLOGY OF MISSOURI, LLC is a dermatology in Saint Louis, MO. The provider is 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. EPIPHANY DERMATOLOGY OF MISSOURI, LLC NPI is 1528573342. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2325 DOUGHERTY FERRY RD STE 201
SAINT LOUIS, MO
ZIP 63122-356
Phone: (314) 993-1714

The provider's authorized official is Gheorghe Pusta .
The authorized official title is Ceo and has the following contact phone number (512) 628-0465.

The CLIA number assigned to this NPI record is 26D2144792 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 12/4/2017 and was last updated on 12/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207N00000XDermatologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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