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 | 9 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 |
---|---|---|
Boonslick Medical Group Inc | 3779481510 | 7 |
Meramec Dermatology Llc | 4082941604 | 10 |
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: Medicare Enrolled 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 |