Individual
DR. MARK H GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 N NEW BALLAS RD, SUITE 110, SAINT LOUIS, MO 63141-6825
(314) 872-8470
(314) 872-8472
Mailing address
555 N NEW BALLAS RD STE 110, SAINT LOUIS, MO 63141-6884
(314) 872-8470
(314) 872-8472
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
100578
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
920674500
—
MO
Enumeration date
07/17/2006
Last updated
03/19/2021
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