Individual
DR. GARY GADDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63110-1014
(314) 362-9123
(314) 747-3338
Mailing address
660 S EUCLID AVE, C B 8072, SAINT LOUIS, MO 63110-1010
(314) 362-9123
(314) 747-3338
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
R5J76
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417060310
—
MO
Enumeration date
08/16/2006
Last updated
01/24/2018
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