ADVANCED DERMATOLOGY OF SOUTHEAST MISSOURI PC

CAPE GIRARDEAU, MO
NPI1770713950
Entity TypeOrganization
Authorized ContactCHARLES MORRIS MOON
President
573-335-7546
Organization Subpart ?No
Primary Taxonomy207N00000X Dermatology
(Licence: MO  2007038037)
Enumeration Date2009-07-22
Last Update Date2021-09-15
Business Address
ADVANCED DERMATOLOGY OF SOUTHEAST MISSOURI PC
2116 MEGAN DR STE 102
CAPE GIRARDEAU, MO 63701-1979
Phone number: 573-335-7546
Mailing Address
ADVANCED DERMATOLOGY OF SOUTHEAST MISSOURI PC
1359 N MOUNT AUBURN RD
CAPE GIRARDEAU, MO 63701-1727
Phone number: 573-335-7546
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