Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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St Charles County Dermatologic Surgery, LLC

Organization Procedural Dermatology Physician · NPI 1235761438

St Charles County Dermatologic Surgery, LLC is a Procedural Dermatology Physician in Cottleville, Missouri. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1493 Cottleville Pkwy
Cottleville, MO 63376-3564
Phone: (636) 317-3376
Fax: (636) 244-1197
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Procedural Dermatology Physician (primary) Taxonomy 207NS0135X

Record details

NPI number1235761438
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stacey Tull — Physician And Owner · (636) 327-3376
NPI enumeratedFebruary 6, 2020
Last updated in NPPESFebruary 6, 2020
Certification dateFebruary 6, 2020
Mailing address1493 Cottleville Pkwy, Cottleville, MO 63376-3564