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Organization
SSM DEPAUL MEDICAL GROUP, INC.
Active
Organization
SSM DEPAUL MEDICAL GROUP, INC.
Active
Other names
Gateway Ob-Gyn
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURA LYNN PULLUM (DIRECTOR OF PATIENT ACCOUNTS)
(314) 209-8121
Entity
Organization
Contact information
Practice address
12277 DE PAUL DR, SUITE 403, BRIDGETON, MO 63044-2516
(314) 344-7585
(314) 344-2879
Mailing address
12277 DE PAUL DR, SUITE 403, BRIDGETON, MO 63044-2516
(314) 344-7585
(314) 344-2879
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
08/11/2006
Last updated
08/22/2020
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