Organization
AESTHETIC DERMATOLOGIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIN SCOTT GARDNER M.D. (PHYSICIAN/OWNER)
(314) 849-7546
Entity
Organization
Contact information
Practice address
9717 LANDMARK PARKWAY DR, SUITE 115, SAINT LOUIS, MO 63127-1628
(314) 849-7546
(314) 849-7558
Mailing address
PO BOX 270686, SAINT LOUIS, MO 63127-0686
(314) 849-7546
(314) 849-7558
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2001005039
MO
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
2001005039
MO
207ND0900X
Dermatopathology Physician
2001005039
MO
207NP0225X
Pediatric Dermatology Physician
2001005039
MO
207NS0135X
Procedural Dermatology Physician
2001005039
MO
Other
Enumeration date
08/19/2007
Last updated
08/27/2009
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