Shane A Grace
Dermatologist
12855 N 40 Dr Ste 180
Saint Louis
, Missouri 63141-8657
Shane A Grace
Dermatologist
12855 N 40 Dr Ste 180
Saint Louis
, Missouri 63141-8657
(920) 684-1439
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About
Features
Specialties
- Dermatologist
Languages spoken
- English
Location
First Address
- Shane A Grace
- 801 York St
- Manitowoc, WI
- Zip : 54220-4630
- Fax : (920) 684-1439
- Phone : (920) 663-9008
Second Address
- Shane A Grace
- 12855 N 40 Dr Ste 180
- Saint Louis, MO
- Zip : 63141-8657
- Fax : (314) 392-4290
- Phone : (314) 878-5599
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | 2020038382 | MO |
National Provider Identifier
| NPI | 1033527684 |
|---|---|
| Provider Name | Shane A Grace |
| First Address | Manitowoc, WI 54220-4630 |
| Second Address | Saint Louis, MO 63141-8657 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/07/2014 |
| Last Update Date | 12/07/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.