Individual
DR. LEONID SHMUYLOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, DIV IM DERMATOLOGY, STE 2A, SAINT LOUIS, MO 63110-1002
(314) 273-3376
(314) 454-4232
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 273-3376
(314) 454-4232
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2018023418
MO
207R00000X
Internal Medicine Physician
2018023418
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200086839
—
MO
Enumeration date
06/12/2015
Last updated
04/17/2025
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