Provider Demographics
NPI:1104868058
Name:GALAKATOS, GREGORY R (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:R
Last Name:GALAKATOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:POST OFFICE BOX 50308
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105
Mailing Address - Country:US
Mailing Address - Phone:314-567-5850
Mailing Address - Fax:314-395-2464
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:SUITE 5015-B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-567-5850
Practice Address - Fax:314-395-2464
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2014-09-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO110323207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0900351OtherUNITED HEALTH CARE
MO293165OtherHEALTHLINK
MO204795017Medicaid
MO106554OtherBLUE CROSS BLUESHIELD
MO83372V3223OtherGROUP HEALTH PLAN
MO200043974OtherRAILROAD MEDICARE
MO5243149OtherAETNA
MO293165OtherHEALTHLINK
MO83372V3223OtherGROUP HEALTH PLAN
MO041012295Medicare ID - Type Unspecified