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St Louis Dermatology LLC

Dermatology Physician in Fenton, MO · enumerated 2013 · authorized official Jeffrey Petersen, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1760810543

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Registry record

Entity type Organization (Type 2)
Legal business name St Louis Dermatology LLC
Practice address 1011 Bowles Avenue, Suite 121, Fenton, MO, 63026
Phone (314) 200-2713
Fax (314) 200-2714
Enumeration date Oct 14, 2013
Last updated in NPPES Feb 18, 2014

Taxonomy & classification

207N00000X Dermatology Physician Allopathic & Osteopathic Physicians · License 2001020599 (MO) Primary

Authorized official

Name Jeffrey Petersen
Title Owner
Phone (314) 200-2713

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for St Louis Dermatology LLC?
NPPES lists Jeffrey Petersen (Owner) as the authorized official for this organization.
What is the NPI number for St Louis Dermatology LLC?
The NPI for St Louis Dermatology LLC is 1760810543, a Type 2 (organization) record in the CMS NPPES registry.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-02-18.