Organization
GATEWAY NEPHROLOGY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIK DANIELS M.D. (PHYSISICAN)
(314) 741-4411
Entity
Organization
Contact information
Practice address
11125 DUNN RD, SUITE 410, SAINT LOUIS, MO 63136-6132
(314) 741-4411
Mailing address
11125 DUNN RD, SUITE 410, SAINT LOUIS, MO 63136-6132
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
111769
MO
Other
Enumeration date
02/06/2009
Last updated
03/24/2010
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