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General NPI Number Information
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NPI Number | 1316006190
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Entity Type | Organization
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Legal Business Name | FELICITAS Z. GATCHALIAN MD, LLC
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 1035 BELLEVUE AVE SUITE 411
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City | SAINT LOUIS
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State | MO
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Zip | 63117-1854
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Country | US
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Telephone | 314-644-3433
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Fax | 314-644-3235
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Provider Business Mailing Address
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Address Line | PO BOX 504479
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City | SAINT LOUIS
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State | MO
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Zip | 63150-0001
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Country | US
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Telephone | 314-989-0300
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Fax |
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Authorized Official
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Title or Position | MANAGING EMPLOYEE
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Name | MS. FELICITAS GATCHALIAN
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Credential | MD
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Telephone | 314-644-3433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 36374
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License Number State | MO
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