Organization
GATEWAY HEALTH CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM WRIGHT CLENDENIN M.D. (PRESIDENT)
(314) 567-0560
Entity
Organization
Contact information
Practice address
7428 ETHEL AVE, SAINT LOUIS, MO 63117-1608
(314) 567-0560
(314) 989-1336
Mailing address
7428 ETHEL AVE, SAINT LOUIS, MO 63117-1608
(314) 567-0560
(314) 989-1336
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MDR 3819
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21842
BLUE CROSS BLUE SHIELD
MO
Enumeration date
11/12/2007
Last updated
02/08/2008
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