Organization
GATEWAY HOSPITALIST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOHAMMED HAQUE MD (OWNER)
(314) 713-3665
Entity
Organization
Contact information
Practice address
4455 DUNCAN AVE, SAINT LOUIS, MO 63110-1111
(314) 658-3800
(636) 333-4510
Mailing address
PO BOX 1449, MARYLAND HEIGHTS, MO 63043-0449
(314) 713-3665
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2000160353
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507420701
—
MO
Enumeration date
06/16/2006
Last updated
12/03/2023
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