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AESTHETIC DERMATOLOGIC SURGERY NPI 1982897450


NPI Information

NPI: 1982897450
Provider Name: AESTHETIC DERMATOLOGIC SURGERY
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

Address:
9717 LANDMARK PARKWAY DR
SUITE 115
SAINT LOUIS, MO
ZIP 63127
Phone: (314) 849-7546
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AESTHETIC DERMATOLOGIC SURGERY is a mohs-micrographic surgery dermatology in Saint Louis, MO. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. AESTHETIC DERMATOLOGIC SURGERY NPI is 1982897450. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

9717 LANDMARK PARKWAY DR
SUITE 115
SAINT LOUIS, MO
ZIP 63127-628
Phone: (314) 849-7546
Fax: (314) 849-7558

The provider's authorized official is Erin Scott Gardner .
The authorized official title is Physician/owner and has the following contact phone number (314) 849-7546.

The enumeration date for this NPI number is 8/19/2007 and was last updated on 8/27/2009.


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
1207N00000XDermatology2001005039MISSOURINo
2207ND0900XDermatologyDermatopathology2001005039MISSOURINo
3207NP0225XDermatologyPediatric Dermatology2001005039MISSOURINo
4207NS0135XDermatologyProcedural Dermatology2001005039MISSOURINo
5207ND0101XDermatologyMOHS-Micrographic Surgery2001005039MISSOURIYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000013522MEDICARE PIN
2000013523MEDICARE PIN
3H23275MEDICARE UPIN

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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