| Mark H Gregory Md Pc | |
|
555 N New Ballas Rd Suite 101 Saint Louis MO 63141-6825 | |
| (314) 872-8470 | |
| (314) 872-8471 |
| Full Name | Mark H Gregory Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 555 N New Ballas Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | Mark Gregory (OWNER) |
| Authorized Official Contact | 3148728470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark H Gregory Md Pc Po Box 445 Sullivan MO 63080-0445 Ph: (573) 468-6501 | Mark H Gregory Md Pc 555 N New Ballas Rd Suite 101 Saint Louis MO 63141-6825 Ph: (314) 872-8470 |
| NPI Number | 1033588256 |
|---|---|
| Provider Enumeration Date | 09/17/2015 |
| Last Update Date | 09/17/2015 |
| Medicare PECOS PAC ID | 1254634066 |
|---|---|
| Medicare Enrollment ID | O20160127002147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033588256 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 100578 (Missouri) | Primary |
| Provider Name | Mark H Gregory |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104843663 PECOS PAC ID: 9234107111 Enrollment ID: I20040918000191 |
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