OrganizationActive
Alliance Health & Dermatology
NPI 1790818599 · Family Medicine Physician · Cape Girardeau, MO
Provider details
- NPI number
- 1790818599
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ramiro Icaza, Administrator(573) 243-2154
- License
- MDR7D79 (MO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
304 S Mount Auburn Rd
Cape Girardeau, MO 63703-4920
Phone: (573) 803-3331
Fax: (573) 803-2905
Approximate (ZIP-level) locationGet directions
Mailing address
304 S Mount Auburn Rd
Cape Girardeau, MO 63703-4920
Other names (DBA / former)
- Other name
- C/O Ramiro Icaza
- Other name
- C/O Ramiro Icaza
Registry dates
- Enumerated
- 2007-03-13
- Last updated
- 2020-02-06
- Certified
- 2020-02-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.