Organization
GATEWAY PEDIATRICS, LLC
Active
Other names
Gateway Pediatrics, PA
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA J GRAVES (OFFICE MANAGER)
(410) 912-7000
Entity
Organization
Contact information
Practice address
1415 WESLEY DR, SALISBURY, MD 21801-7130
(410) 912-7000
(410) 912-4202
Mailing address
1415 WESLEY DR, SALISBURY, MD 21801-7130
(410) 912-7000
(410) 912-4202
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2100215P0001
—
MD
Enumeration date
06/03/2009
Last updated
09/30/2022
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