Healthcare Provider Details

I. General information

NPI: 1467518589
Provider Name (Legal Business Name): REGINA CRUZ BOWERS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REGINA ANNE CRUZ M.D.

II. Dates (important events)

Enumeration Date: 01/01/2007
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12200 WEBER HILL RD STE 200
SAINT LOUIS MO
63127-1569
US

IV. Provider business mailing address

12200 WEBER HILL RD STE 200
SAINT LOUIS MO
63127-1569
US

V. Phone/Fax

Practice location:
  • Phone: 314-842-5660
  • Fax: 148-420-1693
Mailing address:
  • Phone: 314-842-5660
  • Fax: 314-842-0169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number2002017786
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: