Organization
ST. LOUIS DERMATOLOGY & COSMETIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON BEAL MD (MEDICAL DIRECTOR)
(314) 422-6882
Entity
Organization
Contact information
Practice address
520 E CHERRY ST, TROY, MO 63379-1410
(314) 834-1400
(314) 834-1430
Mailing address
7354 MARYLAND AVE, SAINT LOUIS, MO 63130-4201
(314) 834-1400
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
207ND0900X
Dermatopathology Physician
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
02/08/2022
Last updated
05/10/2026
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