Healthcare Provider Details

I. General information

NPI: 1104368489
Provider Name (Legal Business Name): UNITED SKIN SPECIALISTS MISSOURI LTD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2016
Last Update Date: 08/16/2024
Certification Date: 08/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 CHESTERFIELD PKWY E SUITE 201
CHESTERFIELD MO
63017-2167
US

IV. Provider business mailing address

33 E 33RD ST FL 12
NEW YORK NY
10016-5362
US

V. Phone/Fax

Practice location:
  • Phone: 636-532-2422
  • Fax: 636-532-2425
Mailing address:
  • Phone: 212-283-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIC S SCHWEIGER
Title or Position: CEO
Credential: MD
Phone: 212-283-3000