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General NPI Number Information
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NPI Number | 1881884658
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Entity Type | Individual
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Provider Name | ZHENGMING GU M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 07/27/2007
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Provider Practice Location Address
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Address Line | 9240 RADIOM DR
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City | SAINT LOUIS
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State | MO
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Zip | 63123-5545
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Country | US
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Telephone | 314-638-4634
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Fax |
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Provider Business Mailing Address
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Address Line | 9240 RADIOM DR
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City | SAINT LOUIS
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State | MO
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Zip | 63123-5545
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Country | US
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Telephone | 314-638-4634
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A95479
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2005000620
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 233527-1
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License Number State | NY
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