Provider Demographics
NPI:1639251978
Name:GATEWAY PEDIATRICS, LTD
Entity type:Organization
Organization Name:GATEWAY PEDIATRICS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:314-770-1844
Mailing Address - Street 1:224 S WOODS MILL RD STE 720
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3513
Mailing Address - Country:US
Mailing Address - Phone:314-434-4010
Mailing Address - Fax:314-434-1714
Practice Address - Street 1:224 S WOODS MILL RD STE 720
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3513
Practice Address - Country:US
Practice Address - Phone:314-434-4010
Practice Address - Fax:314-434-1714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty