Organization
DANIEL D BEKELE LLC
Active
Other names
St. Gabriel Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL DESTA BEKELE MD (MEDICAL DIRCTOR)
(314) 230-9050
Entity
Organization
Contact information
Practice address
6113 RIDGE AVE, SAINT LOUIS, MO 63133
(720) 235-6443
Mailing address
6113 RIDGE AVE, SAINT LOUIS, MO 63133-2616
(314) 230-9050
(885) 281-8576
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
MO
261QU0200X
Urgent Care Clinic/Center
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
830059014
—
MO
Enumeration date
07/19/2018
Last updated
06/11/2019
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