Bassam Malo M.D.

NPI 1205148293 - Student in an Organized Health Care Education/Training Program - 390200000X

NPI Details
NPI 1205148293
Gender Male
Enumeration Date 07/08/2010
Last Updated 07/08/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
1438 S GRAND BLVD
SAINT LOUIS MO, 63104-1027, US
Phone (314) 977-4828
Fax (314) 977-4877
Business Location
1438 S GRAND BLVD
SAINT LOUIS MO, 63104-1027, US
Phone (314) 977-4828
Fax (314) 977-4877
Toxanomy
Taxonomy Code 390200000X
License State Missouri
License Number 2010019819
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According to our database, Bassam Malo M.D. NPI is 1205148293, taxonomy code is 390200000X and license number is 2010019819, license state is located at Missouri. Bassam Malo M.D. physically located at 1438 S Grand Blvd, Saint Louis MO, 63104-1027. NPI Number Bassam Malo M.D. has the Individual type.

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1205148293 NPI number is provided on an as is basis without warranty of any kind. 1205148293 is maintained by the National Plan & Provider Enumeration System. The contents of Bassam Malo M.D. are for informational purposes only.