Organization
TROY DERMATOLOGY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON BEAL MD (CEO/PRESIDENT)
(314) 834-1400
Entity
Organization
Contact information
Practice address
520 E CHERRY ST, TROY, MO 63379-1410
(314) 834-1400
(314) 834-1430
Mailing address
540 E CHERRY ST, TROY, MO 63379-1410
(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
08/06/2024
Last updated
08/06/2024
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