Healthcare Provider Details

I. General information

NPI: 1376538371
Provider Name (Legal Business Name): AMY C NEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1058 OLD DES PERES RD
DES PERES MO
63131-1865
US

IV. Provider business mailing address

1058 OLD DES PERES RD
SAINT LOUIS MO
63131-1865
US

V. Phone/Fax

Practice location:
  • Phone: 314-266-0412
  • Fax: 314-798-1579
Mailing address:
  • Phone: 314-266-0412
  • Fax: 314-798-1579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number2005002894
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: