Healthcare Provider Details

I. General information

NPI: 1760480081
Provider Name (Legal Business Name): JOHN H UHLEMANN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 10/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4921 PARKVIEW PL STE 8C
SAINT LOUIS MO
63110-1032
US

IV. Provider business mailing address

660 S EUCLID AVE C B 8123
SAINT LOUIS MO
63110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-2643
  • Fax: 314-747-8693
Mailing address:
  • Phone: 314-362-2643
  • Fax: 314-747-8693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberR4918
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: