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General NPI Number Information
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NPI Number | 1528008976
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Entity Type | Organization
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Legal Business Name | MISSOURI EM-I MEDICAL SERVICES, P.C.
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 07/28/2015
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Provider Practice Location Address
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Address Line | 3933 S BROADWAY
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City | SAINT LOUIS
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State | MO
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Zip | 63118-4601
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Country | US
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Telephone | 314-865-7000
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Fax | 314-865-7073
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Provider Business Mailing Address
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Address Line | PO BOX 98806
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City | LAS VEGAS
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State | NV
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Zip | 89193-8806
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Country | US
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Telephone | 800-732-1066
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Fax | 630-968-1622
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Authorized Official
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Title or Position | PRESIDENT/GENERAL PARTNER
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Name | DR. JOSEPH H GATEWOOD
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Credential | M.D.
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Telephone | 800-732-1066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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