| Gateway Regenerative Medicine, LLC | |
|
456 N New Ballas Rd Ste 101 Saint Louis MO 63141-6850 | |
| (314) 384-3600 | |
| Not Available |
| Full Name | Gateway Regenerative Medicine, LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 456 N New Ballas Rd Ste 101, Saint Louis, Missouri |
| Authorized Official Name and Position | Robert Crittenden (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3143843600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Regenerative Medicine, LLC 456 N New Ballas Rd Ste 101 Saint Louis MO 63141-6850 Ph: (314) 520-9315 | Gateway Regenerative Medicine, LLC 456 N New Ballas Rd Ste 101 Saint Louis MO 63141-6850 Ph: (314) 384-3600 |
| NPI Number | 1225741143 |
|---|---|
| Provider Enumeration Date | 01/05/2023 |
| Last Update Date | 05/04/2023 |
| Certification Date | 05/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225741143 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
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