| Dr Courtney Champagne Crider, MD | |
|
4800 Mexico Rd Ste 104, Saint Peters, MO 63376-1666 | |
| (636) 204-6447 | |
| (877) 349-7061 |
| Full Name | Dr Courtney Champagne Crider |
|---|---|
| Gender | Female |
| Speciality | Dermatology |
| Experience | 11 Years |
| Location | 4800 Mexico Rd Ste 104, Saint Peters, Missouri |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598146557 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 2015017799 (Missouri) | Secondary |
| 207N00000X | Dermatology | 2019014137 (Missouri) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Meramec Dermatology Llc | 4082941604 | 11 |
| Entity Name | Boonslick Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588662803 PECOS PAC ID: 3779481510 Enrollment ID: O20040727000319 |
| Entity Name | Meramec Dermatology Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902378250 PECOS PAC ID: 4082941604 Enrollment ID: O20190806000111 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Courtney Champagne Crider, MD 4800 Mexico Rd Ste 104, Saint Peters, MO 63376-1666 Ph: (636) 204-6447 | Dr Courtney Champagne Crider, MD 4800 Mexico Rd Ste 104, Saint Peters, MO 63376-1666 Ph: (636) 204-6447 |
Dr. Paul J Gruber, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 5700 Mexico Rd Ste 14, Saint Peters, MO 63376 Phone: 636-277-0371 Fax: 636-447-4161 | |
Aaron Andrew Dwan, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 5700 Mexico Rd Ste 14, Saint Peters, MO 63376 Phone: 636-277-0371 Fax: 636-447-4161 | |
Nora K Shumway, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 201bjc St. Peters Dr, Suite 1a, Saint Peters, MO 63376 Phone: 636-277-0073 Fax: 636-277-0074 |