Organization
ST GABRIEL CLINIC CDM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL DESTA BEKELE MD (OWNER)
(720) 235-6443
Entity
Organization
Contact information
Practice address
6115 RIDGE AVE, SAINT LOUIS, MO 63133-2616
(314) 230-9050
(844) 870-7109
Mailing address
6115 RIDGE AVE, SAINT LOUIS, MO 63133-2616
(314) 230-9050
(844) 870-7109
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/10/2023
Last updated
11/10/2023
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