Provider Demographics
NPI:1518975366
Name:GAMMACK, JULIE K (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:K
Last Name:GAMMACK
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1008 S SPRING AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-2520
Mailing Address - Country:US
Mailing Address - Phone:314-977-8462
Mailing Address - Fax:314-977-3370
Practice Address - Street 1:CENTER FOR SPECIALIZED MEDICINE
Practice Address - Street 2:1221 S. GRAND BLVD, 2ND FLOOR
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104
Practice Address - Country:US
Practice Address - Phone:314-977-6055
Practice Address - Fax:314-977-3370
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2021-03-11
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Provider Licenses
StateLicense IDTaxonomies
MO2003020128207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine