Lake St Louis Dermatology PC
NPI 1255583746ActiveOrganization· Dermatology· Lake St Louis, MO
Dermatology in Lake St Louis, Missouri, registered in NPPES in October 2008. The authorized official on file is Maria J. Canizares-Heyde, MD, Dermatologist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1255583746 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 16, 2008 |
| Last updated in NPPES | Feb 11, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | MO2002031471 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MO) |
|---|
Other Dermatology providers in Lake St Louis
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