Provider Demographics
NPI:1144412339
Name:DE BRUIN, GABRIELA SALES (MD)
Entity Type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:SALES
Last Name:DE BRUIN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-362-1408
Mailing Address - Fax:314-747-4342
Practice Address - Street 1:1600 S BRENTWOOD BLVD
Practice Address - Street 2:DIV NEUROLOGY SLEEP MED, STE 600
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63144-1320
Practice Address - Country:US
Practice Address - Phone:314-362-1408
Practice Address - Fax:314-747-4342
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2024-04-10
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Provider Licenses
StateLicense IDTaxonomies
MO20110206442084N0400X, 2080S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209547207Medicaid