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:
Health care specialties
| Specialty | Code | License # | 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 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750728192 | NPPES |
| Missouri | MEDICAID | 200051946 |
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