Individual
MATTHEW D GAETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1723 BROADWAY ST, SUITE 220, CAPE GIRARDEAU, MO 63701-4505
(573) 331-7910
(573) 331-7919
Mailing address
1723 BROADWAY ST, SUITE 220, CAPE GIRARDEAU, MO 63701-4505
(573) 331-7910
(573) 331-7919
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
2007018011
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007018011
MISSOURI LICENSE
MO
Enumeration date
09/20/2006
Last updated
07/13/2007
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