DELUXE DERMATOLOGY LLC (NPI# 1922605906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1922605906 |
Entity Type | Organization |
Organization Name | DELUXE DERMATOLOGY LLC |
Practice Address |
1034 S Brentwood Blvd Ste 1000 Saint Louis MO 63117-1210 |
Practice Telephone | 3147810794 |
Mailing Telephone | 3147810794 |
Enumeration Date | 2020-10-03 |
Last Update Date | 2020-10-03 |
Authorized Official Name | DR. DUANE ARDIE DILWORTH JR. (PHYSICIAN) |
Authorized Official Telephone | 3147810794 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | MISSOURI BOARD OF REGISTRATION FOR THE HEALING ARTS | 2020010839 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
11125 Dunn Rd Ste 411, Saint Louis, MO 631366132 | 3143557111 | 3143558604 |
Street Address |
1034 S BRENTWOOD BLVD STE 1000 |
City | SAINT LOUIS |
State | MO |
Zip Code | 63117-1210 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255956611 | Efehi Kelly Ogbomo | Student in an Organized Health Care Education/Training Program | 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 | 2020-06-11 |
1619533890 | Abdul Rauf | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 | 2019-05-14 |
1083278477 | Mohamed Maali Gumaa Mohamed | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 | 2019-05-01 |
1750945556 | Samrat Jun Jayanth | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 | 2019-04-26 |
1215491329 | Latonya Allen | Counselor | 1612 S. Big Bend Blvd, St. Louis, MO 63117 | 2019-01-23 |
1265917025 | Blue Stars Therapy, LLC | Occupational Therapist | 1101 Edward Terrace, Apt A, St. Louis, MO 63117 | 2018-09-27 |
1770060014 | Ultra Care Home Services LLC | Home Health | 7353 Dale Ave, Saint Louis, MO 63117 | 2018-07-19 |
1235623562 | Melissa Valerie Taylor | Counselor | Psychological Services of St Louis, LLC, 7110 Oakland Ave, St Louis, MO 63117 | 2018-06-20 |
1124517289 | Jideofor Ebony Obodozie | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-05-04 |
1770071706 | Sivaram Prabhuji Muppaneni | Student in an Organized Health Care Education/Training Program | Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 | 2018-04-25 |
Find all providers in zip 63117 |
Taxonomy Code | 207N00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417597923 | Anna Marie Aiazzi | Dermatology | 10012 Kennerly Rd Ste 401, Saint Louis, MO 63128-2197 | 2020-01-13 |
1821482373 | David Cotter | Dermatology | 9450 Minerva Ave, Saint Louis, MO 63114-3910 | 2015-03-23 |
1710320767 | Mallory Shiver Abate | Dermatology | 1755 S Grand Blvd Dept of Dermatology, Saint Louis, MO 63104-1540 | 2013-04-09 |
1689935728 | Rebecca Joy Chibnall | Dermatology | 5225 Mid America Plz Ste 2300, Ste 2300, Saint Louis, MO 63129-0002 | 2012-06-05 |
1285928697 | Urvi Patel | Dermatology | 522 N New Ballas Rd Ste 316, Ste 316, Saint Louis, MO 63141-6840 | 2011-06-02 |
1235428582 | Hala Fatima Adil | Dermatology | 2315 Dougherty Ferry Rd Ste 200b, Slucare Dermatology, Saint Louis, MO 63122-3383 | 2011-04-06 |
1376852087 | Michael Slade Stratton | Dermatology | 2325 Dougherty Ferry Rd Ste 201, Saint Louis, MO 63122-3356 | 2010-09-29 |
1255643813 | Sarah Alison Finger Basak | Dermatology | 12855 N 40 Dr Ste 180, Saint Louis, MO 63141-8657 | 2010-07-11 |
1285835454 | Nita Kohli | Dermatology | 4901 Forest Park Ave Ste 502, Ste 502, Saint Louis, MO 63108-1402 | 2007-05-29 |
1346372109 | Mark Udey | Dermatology | 4921 Parkview Pl Ste 5a, Ste 5a, Saint Louis, MO 63110-1032 | 2007-03-09 |
Find all providers in SAINT LOUIS |
City | SAINT LOUIS |
Zip Code | 63117 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.