Individual
MARK C GUNBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3844 S LINDBERGH BLVD STE 120, SAINT LOUIS, MO 63127-1369
(314) 525-0490
Mailing address
3844 S LINDBERGH BLVD STE 120, SAINT LOUIS, MO 63127-1369
(314) 525-0490
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
100326
MO
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
100326
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
243773900
—
MO
Enumeration date
08/31/2006
Last updated
02/19/2021
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