ALLIANCE HEALTH & DERMATOLOGY NPI 1790818599

NPI Information

NPI: 1790818599
Provider Name: ALLIANCE HEALTH & DERMATOLOGY

Other Name: C/O RAMIRO ICAZA

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
304 S MOUNT AUBURN RD
CAPE GIRARDEAU, MO
ZIP 63703
Phone: (573) 803-3331
Get Directions

ALLIANCE HEALTH & DERMATOLOGY is a family medicine in Cape Girardeau, MO. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ALLIANCE HEALTH & DERMATOLOGY NPI is 1790818599. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is C/o Ramiro Icaza.

The provider's business location address is:

304 S MOUNT AUBURN RD
CAPE GIRARDEAU, MO
ZIP 63703-920
Phone: (573) 803-3331
Fax: (573) 803-2905

The provider's authorized official is Ramiro Icaza .
The authorized official title is Administrator and has the following contact phone number (573) 243-2154.

The enumeration date for this NPI number is 3/13/2007 and was last updated on 2/6/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		MDR7D79	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	593695703	MEDICAID	MISSOURI

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: 11/14/2023

NPI Synchronization or Removal

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