| Alliance Health & Dermatology | |
|
304 S Mount Auburn Rd Cape Girardeau MO 63703-4920 | |
| (573) 803-3331 | |
| (573) 803-2905 |
| Full Name | Alliance Health & Dermatology |
|---|---|
| Speciality | Family Medicine |
| Location | 304 S Mount Auburn Rd, Cape Girardeau, Missouri |
| Authorized Official Name and Position | Ramiro Icaza (ADMINISTRATOR) |
| Authorized Official Contact | 5732432154 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Health & Dermatology 304 S Mount Auburn Rd Cape Girardeau MO 63703-4920 Ph: (573) 803-3331 | Alliance Health & Dermatology 304 S Mount Auburn Rd Cape Girardeau MO 63703-4920 Ph: (573) 803-3331 |
| NPI Number | 1790818599 |
|---|---|
| Provider Enumeration Date | 03/13/2007 |
| Last Update Date | 02/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790818599 | NPI | - | NPPES |
| 593695703 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MDR7D79 (Missouri) | Primary |
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