National Provider Identifier Database

TERENCE M MYCKATYN, MD – NPI #1598781718
Plastic and Reconstructive Surgery


Contact Information

TERENCE M MYCKATYN, MD
1020 N MASON RD
DIV SURG PLASTICS, MOB 3 STE 110
SAINT LOUIS, MO63141-6666
Phone: 314-362-7388
Fax: 833-301-0853
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X
Plastic Surgery Within the Head and Neck 2082S0099X
Surgery of the Hand 2086S0105X

* Indicates primary specialty

NPI Profile & details for TERENCE M MYCKATYN

NPI Number 1598781718
Credentials MD
Entity Individual
Enumeration date 07/14/2006
Last updated 04/17/2025 - More than a year ago
Sole proprietor1 No
Identifiers
  • MO License #: 2000173749
  • MO Medicaid: 207820606
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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