Individual
DR. MARY CAROLYN GAMACHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
450 N NEW BALLAS RD, SUITE 170, SAINT LOUIS, MO 63141-6835
(314) 993-6969
(314) 993-0792
Mailing address
450 N NEW BALLAS RD, SUITE 170, SAINT LOUIS, MO 63141-6835
(314) 993-6969
(314) 993-0792
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
R6H99
MO
207UN0901X
Nuclear Cardiology Physician
R6H99
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203017025
—
MO
Enumeration date
07/01/2005
Last updated
06/10/2011
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