Organization
GEORGE DERMATOLOGY, LLC
Active
Organization
GEORGE DERMATOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY NOEL GEORGE MD (OWNER)
(314) 344-0004
Entity
Organization
Contact information
Practice address
12255 DEPAUL DRIVE, 770 NORTH BUILDING, BRIDGETON, MO 63044-2515
(314) 344-0004
(314) 344-0631
Mailing address
12255 DEPAUL DRIVE, 770 NORTH BUILDING, BRIDGETON, MO 63044
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2006009450
MO
Other
Enumeration date
11/07/2017
Last updated
06/16/2018
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