Organization
GAETA GASTROENTEROLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH HOLT (PRACTICE ADMINISTRATOR)
(573) 334-3074
Entity
Organization
Contact information
Practice address
465 S MOUNT AUBURN RD, SUITE 102, CAPE GIRARDEAU, MO 63703-4926
(573) 388-3939
Mailing address
60 DOCTORS PARK, CAPE GIRARDEAU, MO 63703-4928
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
LC001429408
MO
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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