MEDICARE: DR. OLIVER A MCKEE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	36494	MO

General Provider Information

NPI Number	:	1366440042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OLIVER A MCKEE MD

Provider Business Mailing Address
First Line	:	2325 DOUGHERTY FERRY RD
Second Line	:	STE 201
City	:	SAINT LOUIS
State	:	MO
Zip	:	63122-3356
Country	:	US
Telephone Number	:	314-993-1714
Fax Number	:	314-993-1718

Provider Business Practice Location Address
First Line	:	2325 DOUGHERTY FERRY RD
Second Line	:	STE 201
City	:	SAINT LOUIS
State	:	MO
Zip	:	63122-3356
Country	:	US
Telephone Number	:	314-993-1714
Fax Number	:	314-993-1718

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/27/2016

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