ADVANCED DERMATOLOGY OF SOUTHEAST MISSOURI PC – NPI #1770713950
Dermatology

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

ADVANCED DERMATOLOGY OF SOUTHEAST MISSOURI PC is a dermatologist located in CAPE GIRARDEAU, MO. NPPES has assigned the NPI number 1770713950 to ADVANCED DERMATOLOGY OF SOUTHEAST MISSOURI PC on July 22, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207N00000X from the Health Care Provider Taxonomy code set, which is classified as Dermatology.

The NPI profile was previously updated about 5 years ago on Sep 15, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ADVANCED DERMATOLOGY OF SOUTHEAST MISSOURI PC below.

NPI Profile for
ADVANCED DERMATOLOGY OF SOUTHEAST MISSOURI PC

NPI Number
1770713950
Enumeration Date

(about 17 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ADVANCED DERMATOLOGY OF SOUTHEAST MISSOURI PC
Primary location
2116 MEGAN DR STE 102
CAPE GIRARDEAU, MO 63701-1979
Phone: (573) 335-7546 Fax: (573) 335-7550
Mailing address
1359 N MOUNT AUBURN RD
CAPE GIRARDEAU, MO 63701-1727
Phone: (573) 335-7546 Fax: (573) 335-7550
Organization Subpart
No
Authorized Official
CHARLES MOON
PRESIDENT
Phone: (573) 335-7546
Updated
Certification Date
Sep 10, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207N00000X
- Dermatology (Primary)
MO 2007038037

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.