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Individual

GARY DAVID KOENIG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 VILLAGE SQ, HAZELWOOD, MO 63042-1820
(314) 355-4010
(314) 355-9484
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(314) 355-4010
(314) 355-9484

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MDR3G44
MO
207RG0100X
Gastroenterology Physician
RG344
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
202823316
MO
Enumeration date
08/25/2005
Last updated
02/16/2026
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