Gabriels Pride Pediatrics

NPI #1124285028 in Ofallon, Illinois

Provider Information

NPI Number: 1124285028
Entity Type: Organization
Organization Name: Gabriels Pride Pediatrics
Primary Specialty: Pediatrics
Enumeration Date: May 19, 2008
Last Updated: May 19, 2008

Practice Location

Address: 1337 PARK PLAZA DRIVE
Address 2: SUITE 1
City: Ofallon
State: Illinois
ZIP Code: 62269-1777
Phone: (618) 624-7391

Authorized Official

Name: DR. THOMAS EDMUND LEVVAULH, MD
Title: MD PRESIDENT OWNER
Phone: (618) 624-7391

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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