Individual
SAMANTHA GAMMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1402 S GRAND BLVD, FDT 14TH FLOOR, SAINT LOUIS, MO 63104-1004
(314) 577-8762
Mailing address
1402 S GRAND BLVD, SAINT LOUIS, MO 63104-1004
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2016013263
MO
Other
Enumeration date
04/04/2013
Last updated
06/16/2016
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