Individual
DR. MOATAZ M GADDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 S WOODS MILL RD, CHESTERFIELD, MO 63017-3625
(314) 205-6050
(314) 434-5939
Mailing address
222 S WOODS MILL RD, CHESTERFIELD, MO 63017-3625
(314) 205-6050
(314) 434-5939
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036153985
IL
207R00000X
Internal Medicine Physician
2012017419
MO
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
036153985
IL
207RP1001X
Pulmonary Disease Physician
036153985
IL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
036153985
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255694600
—
WI
Enumeration date
06/20/2012
Last updated
09/22/2020
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