Provider Demographics
NPI:1891964730
Name:GATEWAY INTERNAL MEDICINE ASSOCIATES PA
Entity Type:Organization
Organization Name:GATEWAY INTERNAL MEDICINE ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ONYEMA
Authorized Official - Middle Name:E
Authorized Official - Last Name:AMAKIRI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:915-422-9795
Mailing Address - Street 1:10201 GATEWAY BLVD W
Mailing Address - Street 2:SUITE 301
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7652
Mailing Address - Country:US
Mailing Address - Phone:915-422-9795
Mailing Address - Fax:
Practice Address - Street 1:10201 GATEWAY BLVD W
Practice Address - Street 2:SUITE 301
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7652
Practice Address - Country:US
Practice Address - Phone:915-422-9795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8488207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty