# GATEWAY REGENERATIVE MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225741143
- **Authorized official:** ROBERT CRITTENDEN (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (314) 384-3600

## Contact information

- **Practice address:** 456 N NEW BALLAS RD STE 101, SAINT LOUIS, MO 63141-6850
- **Practice address phone:** (314) 384-3600
- **Mailing address:** 456 N NEW BALLAS RD STE 101, SAINT LOUIS, MO 63141-6850
- **Mailing address phone:** (314) 520-9315

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/05/2023
- **Last updated:** 05/04/2023