Organization
SUSAN D PURCELL MD DERMATOLOGY LLC
Active
Other names
Purcell Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN D PURCELL MD (OWNER)
(314) 985-8000
Entity
Organization
Contact information
Practice address
969 N MASON RD STE 170, SAINT LOUIS, MO 63141-6387
(314) 888-5305
Mailing address
969 N MASON RD STE 170, SAINT LOUIS, MO 63141-6387
(314) 985-8000
(314) 985-8004
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
2008007453
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831244904
NPI
—
Enumeration date
10/16/2016
Last updated
12/12/2016
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