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General NPI Number Information
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NPI Number | 1639251978
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Entity Type | Organization
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Legal Business Name | GATEWAY PEDIATRICS, LTD
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 224 S WOODS MILL RD STE 720
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3513
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Country | US
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Telephone | 314-434-4010
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Fax | 314-434-1714
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Provider Business Mailing Address
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Address Line | 224 S WOODS MILL RD STE 720
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City | CHESTERFIELD
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State | MO
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Zip | 63017-3513
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Country | US
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Telephone | 314-434-4010
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Fax | 314-434-1714
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SARA FLETCHER
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Credential | MA
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Telephone | 314-770-1844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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