Organization
LEE S. PORTNOFF, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEE S PORTNOFF M.D. (PRESIDENT)
(314) 993-2909
Entity
Organization
Contact information
Practice address
3009 N BALLAS RD, STE 235A, SAINT LOUIS, MO 63131-2308
(314) 993-2909
Mailing address
3009 N BALLAS RD, STE 235A, SAINT LOUIS, MO 63131-2308
(314) 993-2909
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
R9730
MO
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
R9730
MO
207NS0135X
Procedural Dermatology Physician
R9730
MO
Other
Enumeration date
05/22/2007
Last updated
09/20/2007
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