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Organization

SSM DEPAUL MEDICAL GROUP, INC.

Active
Other names
Gateway Ob-Gyn
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LAURA LYNN PULLUM (DIRECTOR OF PATIENT ACCOUNTS)
(314) 209-8121
Entity
Organization

Contact information

Practice address
12277 DE PAUL DR, SUITE 403, BRIDGETON, MO 63044-2516
(314) 344-7585
(314) 344-2879
Mailing address
12277 DE PAUL DR, SUITE 403, BRIDGETON, MO 63044-2516
(314) 344-7585
(314) 344-2879

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary

Other

Enumeration date
08/11/2006
Last updated
08/22/2020
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