Itani, Malak

Itani, Malak is an individual health care provider with primary practice located at 510 S Kingshighway Blvd Dept Radiology, Saint Louis MO 63110-1016. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Medicine, Allopathic & Osteopathic Physicians / Body Imaging. Allopathic & Osteopathic Physicians / Body Imaging is her primary health care specialty. Itani, Malak can be contacted via phone (314) 362-7200.

Contact Information

Primary practice address
510 S Kingshighway Blvd Dept Radiology Saint Louis MO 63110-1016
Phone: (314) 362-7200
Fax: (314) 747-4189
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nuclear Medicine 207U00000X 2017043456 Missouri
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X 2017043456 Missouri

Profile Details

NPI number 1750728192
LBN Legal business name Itani, Malak
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2013
Last updated Apr 25th, 2024 - about 5 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750728192 NPPES
Missouri MEDICAID 200051946

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