Individual
DR. ERIN SCOTT GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3009 N BALLAS RD STE 300A, SAINT LOUIS, MO 63131-2354
(314) 997-7546
(314) 997-7558
Mailing address
PO BOX 31236, SAINT LOUIS, MO 63131-0236
(314) 997-7546
(314) 997-7558
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2001005039
MO
207ND0101X
MOHS-Micrographic Surgery Physician
2001005039
MO
207NS0135X
Procedural Dermatology Physician
2001005039
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070016410
RR MEDICARE - STL OFFICE
MO
01
—
070016411
RR MEDICARE - CAPE OFFICE
MO
01
—
152349
BLUE CROSS BLUE SHIELD MO
MO
01
—
36-4447622
MERCY
MO
01
—
36-4447622-71631
AETNA
MO
01
—
364447622
UNITED HEALTHCARE
MO
01
—
364447622 63703 A001
TRICARE
MO
01
—
3644476220001
RR MEDICARE
MO
Enumeration date
06/25/2005
Last updated
03/04/2022
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