Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Skin Surgery Center of Missouri, LLC

Organization Procedural Dermatology Physician · NPI 1760662514

Skin Surgery Center of Missouri, LLC is a Procedural Dermatology Physician in O Fallon, Missouri. Licensed in Missouri. Registered with an NPI since 2007.

Licensed in
MO
In the registry since
2007
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

6704 Keaton Corporate Pkwy Ste 100
O Fallon, MO 63368-8680
Phone: (636) 300-9596
Fax: (636) 300-9598
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Procedural Dermatology Physician (primary) Taxonomy 207NS0135X (MO)

Record details

NPI number1760662514
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Saadia Raza — Director · (314) 276-0385
NPI enumeratedNovember 9, 2007
Last updated in NPPESJanuary 11, 2021
Certification dateJanuary 11, 2021
Mailing address6704 Keaton Corporate Pkwy, O Fallon, MO 63368-8680