Gamache, Mary Carolyn

Gamache, Mary Carolyn is an individual health care provider with primary practice located at 450 N New Ballas Rd Suite 170, Saint Louis MO 63141-6835. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Cardiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is her primary health care specialty. Gamache, Mary Carolyn can be contacted via phone (314) 993-6969.

Contact Information

Primary practice address
450 N New Ballas Rd Suite 170 Saint Louis MO 63141-6835
Fax: (314) 993-0792
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nuclear Cardiology 207UN0901X R6H99 Missouri
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X R6H99 Missouri

Profile Details

NPI number 1639176860
LBN Legal business name Gamache, Mary Carolyn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2005
Last updated Jun 10th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639176860 NPPES
Missouri MEDICAID 203017025

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